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TRANSCRIPT OF PROCEEDINGS
Fair Work Act 2009����������������������������������������������������

 

JUSTICE ROSS, PRESIDENT

DEPUTY PRESIDENT ASBURY

COMMISSIONER O'NEILL

 

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

 

Melbourne

 

9.00 AM, TUESDAY, 10 MAY 2022

 

Continued from 09/05/2022

 


PN10214  

COMMISSIONER O'NEILL:  Good morning.  Unless there's anything anyone wishes to raise, do we have - I think it's Ms Wagner up first?  And I think she's here, and I can see her nodding.

PN10215  

Ms Wagner, you can hear me all right?

PN10216  

MS WAGNER:  Yes, I can.  Thank you.

PN10217  

COMMISSIONER O'NEILL:  All right.  My associate is just going to take you through the affirmation.

PN10218  

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

PN10219  

MS WAGNER:  Susanne Wagner, 24 Sunderland Street, Moonah, Tasmania.

<SUSANNE WAGNER, AFFIRMED�������������������������������������������������� [9.01 AM]

EXAMINATION-IN-CHIEF BY MS DOUST������������������������������������ [9.01 AM]

PN10220  

COMMISSIONER O'NEILL:  Ms Doust?  No ‑ ‑ ‑

PN10221  

MS DOUST:  Thank you, Commissioner.

PN10222  

Ms Wagner, can you please state your full name for the record?‑‑‑Susanne Wagner.

PN10223  

And are you a support worker employed by community based support in Moonah, Tasmania?‑‑‑That's correct.

PN10224  

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

PN10225  

Do you have a copy of that statement with you?‑‑‑I do.

PN10226  

For the record that's document 204 in the digital court book at page 11,296.

***������� SUSANNE WAGNER�������������������������������������������������������������������������������������������������������������������� XN MS DOUST

PN10227  

Ms Wagner, since you made that statement, has there been some change to your pattern of employment, that being that you've been working less hours because of a workplace injury?‑‑‑That's correct.  And we had a conciliation meeting yesterday, so the condition of the agreement was that I resign.

PN10228  

Subject to that, is the statement otherwise true and correct?‑‑‑Absolutely, yes.

PN10229  

I read that, Commissioner.

PN10230  

COMMISSIONER O'NEILL:  Yes.

PN10231  

MS DOUST:  Thank you.

PN10232  

COMMISSIONER O'NEILL:  Mr Ward.

CROSS-EXAMINATION BY MR WARD������������������������������������������ [9.03 AM]

PN10233  

MR WARD:  Thank you, Commissioner.

PN10234  

Ms Wagner, can you hear me?‑‑‑Yes.

PN10235  

Thank you.  Ms Wagner, my name is Nigel Ward.  I appear in these proceedings for the employer interests, and I'm going to ask you some questions.  Do you have your statement in front of you?‑‑‑I do, yes.

PN10236  

Thank you.  Can I just start at paragraph 8 you talk about your certificate III.  You say you got it recently.  When did you get your certificate III?‑‑‑Now, I've got to think.  I think I got it in December of 2021.

PN10237  

2021?‑‑‑Yes.

PN10238  

And where did you do your 120 hour practical?‑‑‑Because I was working while I was studying so it was - I was also getting the practical in the work, yes, in the (indistinct).

PN10239  

So, you're already working and that counted as your practical?‑‑‑Yes.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10240  

Okay.  And you say in your statement at paragraph 5 that you had 17 years' experience in home care in the United Kingdom.  Were you allowed to do more in home care in terms of nature of work you did in England compared to Australia?‑‑‑It was a different scenario because I was doing 24-7 care, so I was in - it's not home care going from a person's home, you know, from home to home.  But the nature of the work was the same and I would say even higher care.

PN10241  

And were you qualified in the UK to do that, or did you just do that based on experience?‑‑‑I did it based on experience.

PN10242  

I just want to clarify if I can in your statement where you talk about the UK.  Am I right that paragraph 28, 29 and 30 you're talking about your UK experience, not your Australian experience?  Could you have a look at that?‑‑‑Twenty-eight, 29 and 30?  Yes, 29, yes, 30.

PN10243  

So, that's a reference to something you did in the United Kingdom, is it?‑‑‑That's right, yes.

PN10244  

And is it the same for paragraph 40 to 43?‑‑‑Yes, that's correct.

PN10245  

Paragraph 24 of your statement you say:

PN10246  

Some of the clients I've worked these shifts with had disabilities.

PN10247  

And at various times in your statement you talk about the NDIS.  Do I take it that you were working with both clients with disabilities on occasions and then on other occasions aged care clients?‑‑‑Yes, I had a mix of both clients.

PN10248  

All right.  And if you go to paragraph 15 when you talk about 24 hour shifts, were they sleep over shifts with clients with a disability or were they aged care?‑‑‑Aged care.

PN10249  

Aged care?‑‑‑It wasn't - in the NDIA it's not classed as a sleep over.  It's a 24 hour shift, so it's a different category, yes.

PN10250  

So, you were on duty for 24 hours?‑‑‑We were with a client for 24 hours, but we're only supposed to work a maximum of eight hours in the 24.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10251  

And do I take it you basically resided in their home during that period, did you?‑‑‑That's correct.

PN10252  

Okay?‑‑‑Yes.

PN10253  

Now, you make a number of - sorry, I'll withdraw that.  You say in the statement that you have done a variety of work.  And can I take you then to paragraph 11.  I just want to understand where it fits into CBS.  You say, 'CBS provides home care'.  I assume by that you mean personal care, personal support?‑‑‑That's right, yes.

PN10254  

Then you say, 'a hub service'.  What's a hub service?‑‑‑A hub service is where clients can go and meet together in a house.

PN10255  

Right?‑‑‑And they were entertained for the day.

PN10256  

Okay.  And where you referred to some of your experiences were you involved in the hub service, or were you separate to that?‑‑‑I had a brief period there just filling in while they were getting new staff, yes.

PN10257  

Right.  And then you say 'community social engagement', was that something you were involved in as well?‑‑‑Yes.

PN10258  

Again, some of your experiences in your statement refer to that, do they?‑‑‑In my statements?  Yes, on social support we take clients out to their activities that they want to attend.

PN10259  

And then, lastly, obviously you talk about domestic work, and you talk in your statement about performing domestic work.  Am I right that domestic work isn't covered in your certificate III?‑‑‑Yes, actually that's a good point.  There isn't - yes - no, it doesn't really talk about house cleaning.

PN10260  

That's okay.  I haven't asked anybody else that question.  I thought it's a relevant question, but - and then at paragraph 32 you say this, I just want to read a couple of paragraphs to you if I can, and then ask you a couple of questions.  You say at paragraph 32:

PN10261  

During any visit to a client I need to build a rapport with the client so they'll feel comfortable sharing issues they may have and engage with any conversation.  My work certification -

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10262  

And I'm assuming that's your certificate III?‑‑‑Mm-hm.

PN10263  

Yes?‑‑‑Yes.

PN10264  

'My work certification requires me to know is underpinned by', and you then identify (a), (b), (c), (d), (e), (f).  And then in paragraph 46 you say this about your certificate III:

PN10265  

My certificate III in individual care requires me to take into account the economic diverse social, spiritual, emotional, cultural, physical experiences, needs, disabilities and geographical factors relevant to each client and co-worker having particular regard for the needs and experience of indigenous people.

PN10266  

I take it when you make those comments you're reflecting on the things you learnt, the competencies you developed in the certificate III, are you?‑‑‑That's what the certificate III requires of us.

PN10267  

Right?‑‑‑Yes.

PN10268  

You then later in paragraph 46 talk about self-education.  You see that?‑‑‑Yes.

PN10269  

Can I just understand this to start with, do you ever do anything in your job outside of your certificate III competencies?‑‑‑Sorry, I'm not sure I understand what you mean by that.

PN10270  

Well, when you finished your certificate III you clearly had a series of competencies, a series of skills that the certificate III gave you?‑‑‑Yes.

PN10271  

And I take it you apply those every day in your job?‑‑‑Yes.

PN10272  

Do you actually do something outside of that basket of skills and competencies that came from your certificate III?‑‑‑No.

PN10273  

Okay.  So when you say you self-educate, help me, what self-educate means?‑‑‑Yes, okay.  So, for example, if we need to know about nutritional requirements of a client then I would research further on that so that I could help the client.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10274  

So, if you were having - I think part of your statement is, is that you talk to a client about eating better, so you might google that, mightn't you?‑‑‑That's right, yes.

PN10275  

Now ‑ ‑ ‑?‑‑‑Sorry, of if I need to know about a cultural background, with the diverse culture that we have, then I would research that when I saw I had a client like that, so I was up-to-date and could communicate better with them.

PN10276  

I see.  Now, I think you say in your statement that you do an environment assessment when you go to a home?‑‑‑That's right.

PN10277  

Could you just describe for me what an environmental assessment includes?‑‑‑Okay.  So it includes firstly when arriving to looking at the outside environment, the footpaths, how steep it is, stairs that are involved, whether the path is slippery or not, so I'm inspecting for hazards and accessibility and also the suitability for the client.  And then when we go inside it's a similar thing, we look - we're doing a hazard check, the risk check, we're looking to see if the environment is appropriate for the client and that there aren't any issues that might be making things difficult for them.

PN10278  

Do you fill out a form with that or is that just something you do in your head?‑‑‑It's just something we do all the time.  If we notice something then we fill out a hazard report or a risk report.

PN10279  

And where does that go to?‑‑‑The coordinators.

PN10280  

Do you do that every time you visit or do you do that at the initial visit?‑‑‑The form or the check?

PN10281  

The checking?‑‑‑Always, because environments change all the time, so - - -

PN10282  

Now, can I just come to - you used the word 'coordinator' then - do you work for the coordinator or do you work for somebody else?‑‑‑Work for - - -

PN10283  

I hate to use the phrase, but who's your boss?‑‑‑Okay.  Well, you can say the executive manager is my boss, and my coordinator is my supervisor.

PN10284  

Okay.  No, that's fine.  Is the coordinator qualified or not, do they have a qualification?‑‑‑Yes.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10285  

What are they?‑‑‑I don't really know.  There are certain certificates I think that they have to have to be a coordinator.

PN10286  

For instance they're not a registered nurse?‑‑‑They could be, but they could also have a Cert IV or whatever's required, sorry, for the coordination, so, yes.

PN10287  

Is it the coordinator's job to set the client up when the client first starts with CBS?‑‑‑Yes, and to ensure that they have their services and to inform them on the services they should - they could have.  They look after the client's package basically.

PN10288  

And is it the coordinator who writes the care plan for the client?‑‑‑That's right.

PN10289  

When do you first see the care plan for the client?‑‑‑When the client appears on our roster and then we need to do the care plan, and then what we do is (indistinct) back to the coordinator if the care plan needs changing.

PN10290  

That could be as simple as, 'David doesn't want to shower in the morning, he wants it in the afternoon', it could be that?‑‑‑That's right, it could be as simple as that, yes.

PN10291  

And it might be, 'David's having difficulty with breathing, we need to get a nurse to look at him', it could be something like that?‑‑‑Well, that wouldn't be a care plan, that would be informing the coordinator of higher needs, and then the care plan would then structure care surrounding supporting that condition.  So I would be reporting that the care plan is not sufficient for the client's needs.

PN10292  

I understand.  Can I just explore that a little further while we're on it.  Let's say that you were showering the client and you observed a skin tear who do you report that to, or do you not report it?‑‑‑Well, yes, the first thing I have to respect the client's autonomy, so I tell the client and what they would like me to do.  Depending on the nature of the skin tear I would recommend they see a doctor or a nurse.  I would put it - I would note it in the progress notes and I would also inform the coordinator so they're well aware of what was happening so that they can also ensure that it's followed up and checked.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10293  

And I take it then if there's some different health practitioner required to call then they would follow that up?‑‑‑Yes, and we also make sure, because - you know, sometimes coordinators are busy or things slip by so it's sort of we have to also ensure that it has been followed up, and that's through progress notes and through talking to the client and just ensuring that things are being looked after.

PN10294  

At the end of a session with a client are your progress notes all electronic?‑‑‑Yes.

PN10295  

Bear with me when I describe this - let's say you've showered somebody, could the progress note be as simple as, 'Showered the client today'?‑‑‑Yes, they can be that simple.  What our coordinators prefer that we do is also comment a little bit on the client, you know, did they appear a little bit depressed, were they happy, so that they get a picture of the client and not just the work that's done.

PN10296  

So you will add observations about what you've seen, so I might be less talkative today or I might be eating less and you might add that into your progress notes?‑‑‑That's right.  I've done that quite a few times, or it's an anniversary of a client's spouse's death and they're feeling unhappy, and things like that, because then they - we need to be aware of the need so they get a little bit more emotional support for the client as, you know, for other support workers that come in.

PN10297  

I take it that also is there to help another support worker if they're coming in after you?‑‑‑Yes, that's our way of communicating with each other as well.

PN10298  

Okay.  If you were with a client, let's say the client started to have very serious shortness of breath, is there an emergency procedure you have to follow?‑‑‑Ring triple 0, and you inform the coordinator, and if necessary perform CPR.

PN10299  

I think you've got first aid to do that, haven't you?‑‑‑That's right, yes.  We have to ensure that that's up to date, yes.

PN10300  

I think you make some observations about medications in your statement.  I'm right in that, yes.  Did you have specific medication training as part of your Cert III or not?‑‑‑No.  The workplace will put workers through medication training.  So I can supervise and assist the client to take their own medication, but I can't dispense or give the medication to the client.

PN10301  

You can prompt them that it's time to take their medication, but you don't administer it?‑‑‑That's right.

PN10302  

And that training, was that training provided by CBS or another employer of yours?‑‑‑Well, I used to do a lot of that in England.  It's just something I've always done, yes, and it talks about it in Cert III as well.

PN10303  

Did you do the administer of medications elective in your Cert III?‑‑‑No.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10304  

So I take it that when you came back to Australia they asked if you were medication competent, and I take it you said 'Yes'?‑‑‑(No audible reply)

PN10305  

You didn't do extra training at CBS?‑‑‑They didn't actually ask.  No, sorry.

PN10306  

No, that's all right.  That's fine.  If you get to a client's house and there's no response is there a procedure for dealing with that?‑‑‑Yes, there is.  A first (indistinct) to knock on doors, look in windows, ring the client, and if I still don't get an answer then I ring the coordinator and they take over from there with instructions.

PN10307  

And they will tell you what to do next?‑‑‑That's right, yes.

PN10308  

Now, it's not clear in your statement, but have you ever found yourself in an unsafe situation while you're working with a client?‑‑‑Yes.

PN10309  

Do you have a procedure you're required to follow if that happens?‑‑‑Yes, there are.  It depends on the nature of what's not safe, but in any situation, especially working with people for example with behavioural problems or dementia, things like that, we always have to ensure that we're positioned in a place where we can put ourselves safely, so (indistinct) through the exit, we're not blocking exits and things like that, because if for example a client were to be violent we can't defend ourselves because we're then at risk of injuring the client.  So the best we can do is remove ourselves from the situation and then report to the coordinator, and fill out an incident form.

PN10310  

Okay.  Have you had cause to remove yourself before?‑‑‑I didn't actually have to remove myself, but I was very cautious in my posture and then so that I didn't trigger the client, and once I was - I finished my shift, then I reported immediately to the coordinators.

PN10311  

Can I just take you to a couple parts of the statement now?  Can I ask you to go to 57?‑‑‑Mm-hm.

PN10312  

Paragraph 57 you're giving an example of a client's hip becoming increasingly painful, and you say:

PN10313  

I encouraged her to make an appointment for referral to a physiotherapist.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10314  

I take it that's what you meant earlier about suggesting to a client that they might go and get some extra help somewhere else?‑‑‑Well, it's out the scope of my role.  I'm not qualified.

PN10315  

Yes?‑‑‑And as much as she really just wanted to look up exercises on YouTube, I wasn't qualified, so I needed to inform them that, and so that they get the physio, the physio gives exercises and then I can assist them with those exercises.

PN10316  

I see.  And in 58 you talk about a client cutting his finger, and you say it looked deep.  You then say, 'I applied first aid'.  I take it that's from your first aid ‑ ‑ ‑?‑‑‑That's right.  Yes.  Yes.

PN10317  

If something like happened that your first aid can't sort out, what would you tell the client to do?‑‑‑You see there it's up to their choice, but like with him I was worried about it, and I encouraged him to see a doctor.  I left a note for his family so that they could also follow up, and I informed the coordinator.

PN10318  

Okay?‑‑‑Yes.

PN10319  

I take it if that got more serious you'd ring Triple 0?‑‑‑Yes.  I would do everything I can to encourage the client to have it seen to, you know, even if it - even if I got leave from the workplace to take the client to the doctor, or to the district nurse, because you can't leave a client, you know, with an injury or a wound.  But at the end of the day it's the client's choice.

PN10320  

I see?‑‑‑So when they're being uncooperative then the coordinator takes over and talks to the client and tries to encourage them, yes.

PN10321  

And would the coordinator not only talk to the client, the coordinator might talk to their family?‑‑‑Yes.  Yes.  Yes.

PN10322  

Can I just take you to paragraph 82 briefly?  In 82 you talk about clients you've worked with, and you talk about clients of the service, so, I take it that some of what's in (a), (b), (c), (d) are things you personally experienced?‑‑‑Yes.

PN10323  

And I take it some of them are things other people have you told you about?‑‑‑That's right.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10324  

Is that what you mean by, 'the clients I have worked with or who are clients of the service'?‑‑‑'The clients I've worked with or who are clients of the service I work at'.  I see, yes.  Yes.  Yes, because it's also general.  I mean, if I'm meeting someone with dementia then there are also others that encounter the same thing, yes.

PN10325  

I just wanted to understand, if I could just - I'll just use an example if we can rather than take you through all of them.  If you go to (d), I'll just use (d) as an example, if I can.  You talk about mental health issues including schizophrenia, personality disorders, bipolar, depression, anxiety disorder?‑‑‑Yes.

PN10326  

I take it to the extent that you are dealing with those, I take it that that's something that you're told about in the care plan?‑‑‑Yes, it would be the care plan.

PN10327  

I take it that - does your certificate III training teach you how to deal with those issues?‑‑‑No.

PN10328  

By way of example, how do you know how to provide care support to somebody with schizophrenia?‑‑‑Well, that's where I do my own research.

PN10329  

You do your own research to work out how to work with a schizophrenic?‑‑‑That's right, yes.

PN10330  

And the same would be with bipolar as well, would it?‑‑‑That's right, or if I'm not sure and the best way - I often do a lot of research and the YouTube videos with dementia and dealing with difficult problems with dementia.  So, yes, and that's all in our own personal time and our own incentive.

PN10331  

That's okay.  And if you're struggling dealing with somebody with those conditions, is that when you contact your care coordinator?‑‑‑Yes.  Yes, because then they'd have to assess the care plan, and find better ways that the service can receive good - the client can receive good service.

PN10332  

I take it there might be circumstances where there's a decision made that the client requires clinical support rather than care support?‑‑‑It's quite possible, yes.

PN10333  

Just a moment, if you could.  Ms Wagner, thank you for your evidence.  Commissioner, no further questions?‑‑‑Thank you very much.

RE-EXAMINATION BY MS DOUST������������������������������������������������� [9.28 AM]

PN10334  

MS DOUST:  Thank you.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������ RXN MS DOUST

PN10335  

Ms Wagner, remember you were asked about carrying out an environmental assessment early on in the questions you were asked?‑‑‑Yes.  Sorry, you're not up on screen - you're there, sorry.

PN10336  

Yes.  Can I just take you back to your response to that?  You were asked about whether or not you filled out a form?‑‑‑Yes.

PN10337  

Can you tell me what method you used to fill out the form?‑‑‑It's an app.  On our app, the form.

PN10338  

Yes?‑‑‑Previously to our app sometimes we were - sorry, I forgot to mention that, we were sent to clients for an environment check, and then we would be given a form with a checklist to check various different items.

PN10339  

Can you give me an example of something that you've reported using that app?‑‑‑As far as the environment is concerned?

PN10340  

Yes?‑‑‑A burnt extension cord in the power socket that the workers were having to use for ironing.  That's a hazard.  Lack of hand rails outside the door for the client and they're finding it difficult to navigate a step to get outside, so that a hand rail is needed for safety of the client, frayed loose rugs on the mats that could be a trip hazard.  Yes, sometimes it's pets, you know, that need to be restrained.

PN10341  

Can I just take you to the first example, Ms Wagner, of the burnt extension cord, can you just explain to me the steps that you would take to report that hazard, or any steps you did take in that instance?‑‑‑In that - I took a photo of it, and then on the app I filled out a hazard form, and supplied the photo.

PN10342  

Is that a process where you had the cooperation of the client to report that matter?‑‑‑Yes, that's right.  At the time I didn't, the client wasn't there, he was in his bedroom, and there wasn't a - there was no policy at that point.  We were just told to take a photo of the hazard so that the coordinator could see, but I think once the coordinator contacted the client to say it needed replacing, then we had a restriction that we needed to get the signature of the client before taking a photo.  So that makes it a lot more difficult to actually - not report a hazard but to describe the hazard.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������ RXN MS DOUST

PN10343  

So, it was the case that if you wanted to take a photo of a hazard from a client's premises to report that back to the employer, you could only include the photo if the client actually gave you permission to include the photo?‑‑‑That's correct, otherwise I just have to rely on the description, and then the coordinator would have to go and visit, I guess.

PN10344  

You were asked also about giving feedback about the care plan and writing your progress notes, and it was suggested to you that the progress notes could be as simple as simply that the client wanted the timing of their shower changed.  Do you recall that - - -?‑‑‑I wouldn't put that in progress notes.  That would be a note to the coordinator.

PN10345  

I'm sorry, yes, I think that's right, but I think it was suggested to you that a proposed change to a care plan could be as simple as a change to the timing of the shower?‑‑‑Yes.

PN10346  

Were there some other examples of proposed changes to care plans that you communicated?‑‑‑Yes, a client is becoming less mobile and a greater risk for falls; a client losing interest in eating, so needing more supervision and prompting around meals.

PN10347  

Yes?‑‑‑You want me to think of some more?  I'm done.

PN10348  

No, I'm just making a note, Ms Wagner.  Unless anything comes to mind.  When you answered a question about observing skin tears on a client and whether or not you'd report it, you responded the first thing you have to do is respect the client's autonomy.  Do you recall giving that answer?‑‑‑Yes, I do.  I mean it's dependent on the skin care, if it's minor, but if it's major, of course it needs reporting.

PN10349  

Yes?‑‑‑But it's because (indistinct) always need to know, because it's an incident.

PN10350  

Yes?‑‑‑Yes, you're right, in case there's infection later and so on.  So it always needs to be communicated so that the whole team knows about it.

PN10351  

Yes.  Can I just ask you, you were also asked about whether or not there was a procedure that you were required to adopt if you felt unsafe.  Do you recall those questions?‑‑‑Yes.  Can I just go back to the last one just briefly?

PN10352  

Sorry, yes, please do?‑‑‑If the skin tear occurred during the care, then that would be an incident, and that has to be reported.  But if it's something the client had during the week on their own, then it would be noted that the skin tear is there, because it's not an incident in the workplace.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������ RXN MS DOUST

PN10353  

All right.  I'm sorry, can we go back now to the question of the procedure to adopt when you felt unsafe?‑‑‑Yes.

PN10354  

Your answer, you said � I think you said how you'd respond depends on what it is that's not safe, and you gave the example of people with behavioural problems and dementia, and you also said that you needed to be in a position where none of the exits were blocked, and you also referred to needing to be careful not to risk any injury to a client in the way you responded in that situation.  Can I just ask you, do you have any experience of being with a client and feeling unsafe?‑‑‑Well, there was the one I gave the example of.

PN10355  

Yes.  Are you referring to the example where you said you have to be very cautious so as not to trigger the client?‑‑‑Yes.  I don't really want to give the detail of what that was about.  It was � well, it was like a sexual threat, if you like.  So basically I didn't want to anger the client or trigger the client in any way, but just to de‑escalate, and that's part of what we need to learn to do, is to de‑escalate situations, and then remove yourself from the premises as safely and as soon as possible.

PN10356  

Let's just be clear, when you're talking about a sexual threat, this was a sexual threat that was directed towards you by the client that you were dealing with?‑‑‑No, it was his own sexual behaviour � I mean, I don't know how � how am I to actually describe what happened.

PN10357  

Provided you don't mention the client's name, you can describe the circumstance that you encountered?‑‑‑It was a personal care situation, and it was a new client, and a new client to the workplace as well, so they didn't know much about the client.  He was very restless before the personal care, and during the showering he asked me to wash his beard and his hair, which he could actually do himself, and then he proceeded to masturbate and slammed the door and pushed me out of the way.

PN10358  

Yes?‑‑‑Now he was not trying to engage me, but he was using me to stimulate himself, and so I didn't know what more he might do, you know, so if I addressed him or if I told him it wasn't appropriate.  So I just de‑escalated and behaved as though he was doing what he wanted to do and it had nothing to do with me, staying polite to him and finishing the personal care, leaving and then reporting.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������ RXN MS DOUST

PN10359  

Just tell me, in relation to that situation, what were the matters that you were weighing up in how you responded to it?‑‑‑The matters � I mean I've got a history of a first marriage of abuse, so this was also triggering me a little bit, you know, and so I was concerned he might get aggressive, or try to make advances.  So that was my concern, so that's why I did my best just to de‑escalate and not address the issue with the client.  Sometimes in some situations when a client is perhaps angry or agitated over � whether it's the service they're receiving or the workplace or family issues, we can talk to the client and de‑escalate and work through the issue with them, but in this situation I didn't feel safe to tell the client he was being inappropriate, because he was unknown to me and he was a new client to the workplace, and when I reported it to the coordinator, they were surprised and said we don't know much about him either.

PN10360  

Just in your answer then, you said sometimes when you feel unsafe you can de‑escalate.  Do I take it from that answer that in other circumstances you have felt unsafe for the same or other reasons?‑‑‑Yes.  Yes, you know, clients can get angry over � they want more from the service than they are getting, or they want you to do more than we're allowed to do in the scope of our role, and then they get frustrated and angry, and you need to be able to talk them through � and I mean, the way to de‑escalate is first to affirm how they feel and understand where they're coming from, so that they feel you're not against them, and then to work a process of talking them through to understanding the situation.  If that doesn't work then we would get the coordinator to come and talk to the client, which I had to do.

PN10361  

Thank you.  Can I ask you please, if you don't mind, to go back to paragraph 40, Ms Wagner?‑‑‑Mm.

PN10362  

I think you accepted, or you agreed that paragraph 40 described a client in the UK, is that correct?‑‑‑I'm not sure � no, I'm not sure this one is, because I know this client.  This is a local client in paragraph 40.

PN10363  

So paragraph 40 describes a client that you were dealing with in your work in Australia?‑‑‑That's right.

PN10364  

All right.  Can I just ask you, paragraph 41 refers to work in the UK.  It refers to clients needing a stand day for transfers and so on and the need to check equipment.  Do you deal with any of that such equipment with your clients that you've dealt with in Australia?‑‑‑Yes.  Not stand day.

PN10365  

COMMISSIONER O'NEILL:  Ms Doust, how does that come through - sorry, I just froze for a moment then.  Ms Doust, I was just asking how that arose in cross-examination.

PN10366  

MS DOUST:  It's re-examination, Commissioner, and I say it arises from the questions that were asked about paragraphs 40 to 43.

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������ RXN MS DOUST

PN10367  

COMMISSIONER O'NEILL:  The question about those was simply whether it was referring to the client's experience of the UK rather than Australia.

PN10368  

MS DOUST:  Yes, that's correct, and I'm just asking the witness whether there's similar experiences in Australia.

PN10369  

COMMISSIONER O'NEILL:  All right.  If you can rephrase it in that way, please.

PN10370  

MS DOUST:  Sorry, do you understand, Ms Wagner, I'm just asking you about paragraphs 40 to 43 whether or not the work that you describe there is similar to work that you have carried out in Australia?‑‑‑42, 43, I thought we were referring to - - -

PN10371  

41, 42 and 43?‑‑‑Right.  Yes, I had one situation where I was checking an elderly lady who had quite (audio malfunction) dementia.  Her walker (indistinct) and I noticed one of the brakes was not working on it.  Another time a client's wheelchair, the tyres were going a little bit flat.

PN10372  

COMMISSIONER O'NEILL:  Ms Doust, is there - - -

PN10373  

MS DOUST:  I'm sorry, I thought Ms Wagner was still reading through the paragraph and was going to provide a further response.

PN10374  

THE WITNESS:  I'm sorry, I'm just reading 42 and 43.  43, we do get that too where people are on mobility aids and they need assistance with the shower, and that can be quite difficult sometimes in a client's home, because the bathrooms aren't always designed for a disability, so that can make it a little bit precarious sometimes.

PN10375  

Thank you very much, Ms Wagner.  No further questions, Commissioner.

PN10376  

COMMISSIONER O'NEILL:  All right.  Ms Wagner, thank you for your evidence this morning.  You're excused and free to go?‑‑‑Thank you very much.  Thank you, everybody.

<THE WITNESS WITHDREW����������������������������������������������������������� [9.45 AM]

***������� SUSANNE WAGNER������������������������������������������������������������������������������������������������������������������ RXN MS DOUST

PN10377  

COMMISSIONER O'NEILL:  All right.  So I think, Mr Oski, it's over to you with the UWU witnesses, and I understand we're starting with Ms Wheatley and I understand that she's had difficulties connecting in through Teams and so my associate is going to call her on her mobile as I understand it.  It's not ideal, but I think it's all we can do, Mr Ward.

PN10378  

MR WARD:  That's fine, Commissioner.  That's fine.

PN10379  

COMMISSIONER O'NEILL:  Hello, is that Ms Wheatley?  Ms Wheatley, can you hear me all right?

PN10380  

MS WHEATLEY:  Yes, I can.

PN10381  

COMMISSIONER O'NEILL:  All right.  I'm Commissioner O'Neill and my associate is just going to take you through the affirmation.

PN10382  

THE ASSOCIATE:  Hi, Ms Wheatley, this is Commissioner O'Neill's associate speaking.  Can you hear me okay?

PN10383  

MS WHEATLEY:  Yes.

PN10384  

THE ASSOCIATE:  Can you please say your full name and work address.

PN10385  

MS WHEATLEY:  Paula Grace Wheatley, 129 Dennis Road, Springwood.

<PAULA GRACE WHEATLEY, AFFIRMED����������������������������������� [9.47 AM]

EXAMINATION-IN-CHIEF BY MR OSKI��������������������������������������� [9.47 AM]

PN10386  

COMMISSIONER O'NEILL:  Mr Oski?

PN10387  

MR OSKI:  Thank you, Commissioner.  Good morning, Ms Wheatley, my name is Sheldon Oski, I appear for the UWU in these proceedings.  Can you just repeat your full name for the record?‑‑‑Paula Grace Wheatley.

PN10388  

Now, you've made a statement for the purposes of this proceeding.  The statement is dated 27 October 2021 and runs to 79 paragraphs over seven pages.  Do you have a copy of that statement with you?‑‑‑On my email, yes.

PN10389  

Yes.  Have you had an opportunity to read through it again recently?‑‑‑Yes.

***������� PAULA GRACE WHEATLEY������������������������������������������������������������������������������������������������������������� XN MR OSKI

PN10390  

And is it true and correct to the best of your knowledge and recollection?‑‑‑Yes, but a few things have changed and there was one mistake in that.  Yes.

PN10391  

Could you let us know what things need to be changed and what mistake there was?‑‑‑My work history wasn't quite right.

PN10392  

In what way?‑‑‑I've worked at Blue Care twice.  I left and did agency work for over three years.  If you just give me a minute I can tell you what's right, because I've got my work history in front of me.  So I started aged care at the end of 94 at Betheden Aged Care Community and (indistinct).  (Indistinct) first and then Betheden.  Then from 2001 to 2006 I started at Blue Care.  In 2006 to 2009 I worked for (indistinct) Nursing Agency, a nurse response nursing agency, but in 2009 to current I went back to Blue Care.

PN10393  

Okay.  Was there any other further changes you wanted to make to your witness statement?‑‑‑Yes, I've actually changed my availability and my hours that I work.  Yes, I don't work the weekends any more.

PN10394  

When do you work now?‑‑‑I work Monday, Tuesday, Wednesday and Friday.  So my contracted hours are 40 hours a fortnight.

PN10395  

All right.  Any other further amendments that need to be made to the statement?‑‑‑No.

PN10396  

Thank you, Ms Wheatley.  Commissioner, that statement is at document 247 at page 12,178 of the digital court book, and we seek to rely upon that statement along with the amendments just made just now by Ms Wheatley.

PN10397  

COMMISSIONER O'NEILL:  So the process we have adopted, Mr Oski, with the other witnesses is where there are changes or clarification if you can arrange to incorporate those changes and refile it as a final statement.

PN10398  

MR OSKI:  We can arrange to do that, Commissioner.

PN10399  

COMMISSIONER O'NEILL:  Thank you.  Mr Ward?

CROSS-EXAMINATION BY MR WARD������������������������������������������ [9.51 AM]

PN10400  

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

***������� PAULA GRACE WHEATLEY�������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10401  

Ms Wheatley, my name is Nigel Ward, I appear in these proceedings for the employer interests.  I am just going to ask you some questions.  Do you have your statement in front of you?‑‑‑I can get it.

PN10402  

I just need you to be able to read it.  Do you have it so you can read it in front of you?‑‑‑Yes, just give me a minute.  Yes.

PN10403  

At paragraph 16 you say you're classified as a personal carer.  Am I right that you're a personal carer providing home care support to clients?‑‑‑Yes.

PN10404  

And can I just take you to paragraph 33 to start with.  I just wanted to understand who supervises your work?  Is it the coordinator or the centre manager?‑‑‑The coordinator.

PN10405  

And do you know if the coordinator is a registered nurse or has any qualifications?‑‑‑No, she's not a registered nurse.

PN10406  

That's fine?‑‑‑And I don't know her - yes, I don't know her qualifications.

PN10407  

I take it that the coordinators then report to the centre manager, do they?‑‑‑Yes.

PN10408  

Then on paragraph 37 you talk about schedulers.  Are they the people who build your roster?‑‑‑Yes.

PN10409  

So, if tomorrow you were going to go and see five clients, the schedulers are the ones who put that together, are they?‑‑‑Yes.

PN10410  

DO you know, is it the coordinator who writes the care plans for the client?‑‑‑No, it's the team leaders usually.

PN10411  

Who are the team leaders?‑‑‑Well, that depends.  I think they've changed since I've made the statement.

PN10412  

Well, when you made the statement who were the team leaders?‑‑‑Fiona - I don't now ‑ ‑ ‑

PN10413  

Sorry, you don't need ‑ ‑ ‑?‑‑‑Fiona Biddle.

***������� PAULA GRACE WHEATLEY�������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10414  

No, sorry, you don't need to give their names.  What I'm asking is they're different people to the coordinators, are they?‑‑‑Yes.

PN10415  

So, they're particular jobs that people do, and one of the roles of those jobs is to write the care plan; is that right?‑‑‑Yes.

PN10416  

And do they report to the centre manager as well?‑‑‑To the coordinator.

PN10417  

So the team leader reports to the coordinator?‑‑‑Yes.

PN10418  

You use an app, as I understand it, called Procura.  Is that how you receive the care plan for a client?‑‑‑No, that'd be appointment in a motion.

PN10419  

Is that ‑ ‑ ‑?‑‑‑And that's how we know where to go and when to go, and that's how Blue Care builds the clients.

PN10420  

In what form do you receive a client's care plan?‑‑‑In the support folder that's supposed to be in their - where they live.

PN10421  

So, you don't see their care plan before you turn up?‑‑‑No.

PN10422  

And are you meant to read their care plan?‑‑‑Yes.

PN10423  

Can I ask you to go to paragraph 72 of your statement?  You say in paragraph 72:

PN10424  

Where any issues are identified in relation to the client's health carers are to ring the office and report these.

PN10425  

Could you explain to me what you mean by 'issues identified in relation to the client's health'?‑‑‑Well, if their condition deteriorated or if they, I don't know, got a skin tear or something like that, anything like that.

PN10426  

And who in the office do you talk to?  Is that the coordinator or the team leader?‑‑‑Whoever answers the phone really.

***������� PAULA GRACE WHEATLEY�������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10427  

Do you know what the process is after that?  Do you know what they do with that information?‑‑‑They put it into the dated notes in the client file.

PN10428  

You don't know if they contact the family or contact a nurse or anything like that?‑‑‑Yes, they contact the nurse if - yes.

PN10429  

Is that a nurse who ‑ ‑ ‑?‑‑‑And then the family.

PN10430  

‑ ‑ ‑works with you, with Blue Care, or is that an external nurse?‑‑‑No, it'd be a Blue Care nurse.

PN10431  

I take it that if it was a clinical issue the Blue Care nurse would then go out and visit the client, would they?‑‑‑Yes.  You also say in paragraph 73 you log these issues in Procura, so, am I right that you phone the office and then separately you actually put the issue into your app?‑‑‑Yes.

PN10432  

Paragraph 42 you talk about the work you do, and you say this:

PN10433  

The clients I see are typically requiring house cleaning.

PN10434  

?‑‑‑Yes.

PN10435  

Yes:

PN10436  

Assistance with showering, dressing, medication, meal preparation and feeding.

PN10437  

In terms of medication, have you been separately trained in relation to medication?‑‑‑Yes.

PN10438  

Can you ‑ ‑ ‑?‑‑‑(Indistinct) medication, yes.

PN10439  

And who gives you that training?‑‑‑We get it every year.  I think the centre manager was the last time.

PN10440  

And it's training that's provided by Blue Care, is it?‑‑‑Yes.

***������� PAULA GRACE WHEATLEY�������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10441  

I take it that that trains you to prompt medications.  You don't actually administer medication?‑‑‑Yes, that's correct.

PN10442  

Can I take you to paragraph 47?  You talk in paragraph 47:

PN10443  

When the clients are showering I check the client's skin integrity.

PN10444  

?‑‑‑Yes.

PN10445  

If you noticed a tear in their skin, what's the procedure that you would follow?‑‑‑Well, I'd ask them if they remembered doing it, or how they did it.  Then we have a trauma kit, if it was bleeding right then and there to do - to put a dressing on it.

PN10446  

And is that using your ‑ ‑ ‑?‑‑‑And then ‑ ‑ ‑

PN10447  

‑ ‑ ‑first aid training?‑‑‑Beg your pardon?

PN10448  

Is that using your first aid training?  You say you have a first aid certificate?‑‑‑No, Blue Care provides, like, a trauma kit thing.  It looks a little bit like a first aid kit.

PN10449  

That's okay.  How were you trained in how to do that?‑‑‑First aid, yes.

PN10450  

So that's your first aid training, is it?‑‑‑Yes.

PN10451  

Keep going.  Sorry, keep going?‑‑‑And then I'd report it, document it, and report it.

PN10452  

And let's say it was more than a skin tear, it was a fairly serious injury, is there a procedure you have to follow?  Do you have to ring Triple or something like that?‑‑‑Well, if they fell on the floor I'd ring Triple 0.

PN10453  

Right?‑‑‑Yes.

PN10454  

So if it was something ‑ ‑ ‑?‑‑‑(Indistinct).

***������� PAULA GRACE WHEATLEY�������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10455  

‑ ‑ ‑ beyond your first aid training you ring Triple 0, do you?‑‑‑Yes.

PN10456  

Having rung Triple 0, do you also then ring the coordinators and tell them what's going on?‑‑‑Yes.

PN10457  

Thank you very much, Ms Wheatley.  No further questions, Commissioner?‑‑‑Okay.

PN10458  

COMMISSIONER O'NEILL:  Mr Oski, any re-examination?

PN10459  

MR OSKI:  No questions in re-examination, Commissioner.

PN10460  

COMMISSIONER O'NEILL:  All right.  Ms Wheatley, thank you very much for your evidence this morning.  You're excused and free to go?‑‑‑Okay.  Thank you, bye.

<THE WITNESS WITHDREW��������������������������������������������������������� [10.01 AM]

PN10461  

COMMISSIONER O'NEILL:  I think next is - is it Ms Inglis?

PN10462  

MR OSKI:  Correct, Commissioner.

PN10463  

MR WARD:  Commissioner, could I just indicate that Mr Rafter has got this witness, if I could just seek leave to just withdraw at this stage?

PN10464  

COMMISSIONER O'NEILL:  Of course.

PN10465  

MR WARD:  Thank you, Commissioner.

PN10466  

COMMISSIONER O'NEILL:  Do we have Ms Inglis?  Any issues with Ms Inglis joining?  I understand she's here.  Ms Inglis, can you hear me?

PN10467  

MS INGLIS:  Yes, I can.  Are you - can you hear me?

PN10468  

COMMISSIONER O'NEILL:  Yes.  Are you able to turn your camera on for us?

***������� PAULA GRACE WHEATLEY�������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10469  

MS INGLIS:  Yes.  Is that okay?

PN10470  

COMMISSIONER O'NEILL:  That's lovely.  Thank you for that.  I'm Commissioner O'Neill and my associate is just going to take you through the affirmation.

PN10471  

MS INGLIS:  Okay.

PN10472  

MS ASSOCIATE:  Ms Inglis, can you please say your full name and work address?

PN10473  

MS INGLIS:  Ngari Inglis.  The work address is Strathalbyn Resthaven office.

PN10474  

MS ASSOCIATE:  Thank you.

<NGARI INGLIS, AFFIRMED���������������������������������������������������������� [10.02 AM]

EXAMINATION-IN-CHIEF BY MR OSKI������������������������������������� [10.02 AM]

PN10475  

COMMISSIONER O'NEILL:  Mr Oski.

PN10476  

MR OSKI:  Thank you, Commissioner.

PN10477  

Good morning, Ms Inglis.  My name is Sheldon Oski, I'm appearing for the UWU in these proceedings.  Can you repeat your full name for the record?‑‑‑Ngari Lee Inglis.

PN10478  

Thank you.  I understand you've made a statement for the purposes of these proceedings.  That statement is dated 19 October 2021 and runs to 37 paragraphs over seven pages.  Do you have a copy of that statement with you?‑‑‑I do.

PN10479  

Have you had an opportunity to read through it again?‑‑‑I just had a read before, yes.

PN10480  

It is true and correct to the best of your knowledge and recollection?‑‑‑It is.

***������� NGARI INGLIS����������������������������������������������������������������������������������������������������������������������������������� XN MR OSKI

PN10481  

Excellent. That's at document 245 at page 12,169 of the digital court book and we seek to rely upon that statement.

PN10482  

COMMISSIONER O'NEILL:  Right.

PN10483  

MR OSKI:  Thank you.  Ms Inglis, you're about to see one of the � on the � I believe you will be potentially cross-examined right now?‑‑‑Okay.

PN10484  

COMMISSIONER O'NEILL:  Ms Rafter.

CROSS-EXAMINATION BY MS RAFTER������������������������������������� [10.04 AM]

PN10485  

MS RAFTER:  Hi Ms Inglis, my name's Alana Rafter and I appear for the employer interests in these proceedings, if you can see me?‑‑‑Yes.

PN10486  

I understand you're a home support worker with Resthaven?‑‑‑Correct.

PN10487  

In your role as a home support worker do you report to a coordinator?‑‑‑Yes.

PN10488  

Is that your supervisor for your shifts, your appointments?‑‑‑Yes, although we work alone that's who I would call if I had an issue.

PN10489  

Yes and is your coordinator, are they a registered nurse?‑‑‑Some are, some aren't.

PN10490  

If you needed to contact a registered nurse during an appointment would you contact someone else, I take it?‑‑‑I'd call the office and ask for a registered nurse if there was one available.

PN10491  

Excellent.  I understand you've done some in-house medication competency training with Resthaven?‑‑‑Yes.

PN10492  

Did that include a theory component and a practical component?‑‑‑Yes.

PN10493  

Was the theory component provided by a registered nurse?‑‑‑I'm not sure if our RTO is a registered nurse.

PN10494  

It was through an RTO?‑‑‑Yes.

***������� NGARI INGLIS�������������������������������������������������������������������������������������������������������������������������� XXN MS RAFTER

PN10495  

How long was the theory component of the training?‑‑‑I think - - -

PN10496  

Was it a day, a week, an hour?‑‑‑Probably a couple of hours.

PN10497  

A couple of hours and I note it was through the RTO so did you do a � was it in, like, a classroom-like setting?‑‑‑Correct.

PN10498  

For the practical component were you observed or assessed?  How did that part happen?‑‑‑We were given scenarios and we worked through the scenario under the supervision of the RTO.

PN10499  

Do you have � is there a test or do they just sign off that you've completed it and you're competent?‑‑‑There's a questionnaire at the end of it.

PN10500  

Thank you for that.  I understand that's annual so you do that every year?‑‑‑Yes.

PN10501  

I note that in your work you also will change catheters, the catheter bag?‑‑‑Yes.

PN10502  

Do you get training?  Are you trained how to do that by Resthaven?‑‑‑I think you would.  If you were given a client who had an IDC you would have to have been shown how to do that prior to attending to that client, yes, but it's not an annual training as such.

PN10503  

It's separate, so it doesn't form part of that training?‑‑‑No.

PN10504  

If we stay with the catheter example, so if the care plan says you have to change the catheter, if you saw that it was cloudy or had blood in it, what would you do in that scenario?‑‑‑You would report to an RN.

PN10505  

Report to an RN immediately?‑‑‑Yes, definitely - - -

PN10506  

And � sorry for cutting you off, you said definitely.  And after you report to the RN, would you also make a progress note of that?‑‑‑Yes, we have care plans in houses and we write progress notes each visit.

PN10507  

Are these progress notes on the physical � attached to the physical care plan or do you document these separately?‑‑‑They're attached in the folder to the care plan.

***������� NGARI INGLIS�������������������������������������������������������������������������������������������������������������������������� XXN MS RAFTER

PN10508  

They're handwritten on there?‑‑‑Yes.

PN10509  

Would there be times where you need to email an additional report to the office, or it's just the physical?‑‑‑No, there are times when I send an email off to the coordinator, yes.

PN10510  

Could you give an example of when you may need to email to the coordinator as well?‑‑‑I'm just trying to think of an example.  I would say if I had concerns, say, emotional wellbeing of a client.  I would, you know, for example, if I had just been there and Mrs Jones was having a down day or I noticed she was a little bit dishevelled, I'm questioning her showering.  And then also if she was in her home, like the other day the hot water wasn't coming through, I'd give them a call.  It just depends on the situation but if anything is out of the norm, definitely.  If it was urgent you'd call and, if not, I'd just usually flick off an email.

PN10511  

With your progress notes for each appointment, do you tend to cover all the care given?  So if you showered, gave a medication prompt, you'd write that, or what type of detail do you include?‑‑‑I usually write each part of what I've done and then if that comes under a heading such as there's like a block of acts you perform, I might write in there, 'As per care plan.'

PN10512  

I note at paragraph 13 of your statement you talk about how clients are assessed by a team of people prior to their admission.  Who makes up that team?‑‑‑Paragraph 13?

PN10513  

Yes?‑‑‑I see, so that would be the assessment team.  So the coordinator who would have visited that client prior to any care being put in place would have assessed the needs of that client.

PN10514  

The coordinator goes to the client's house and will they go alone and have a meeting with the client or are they with someone else at that time?‑‑‑I'm not sure, I'm not part of that process.

PN10515  

No worries, then, I won't delve too much deeper into that then, but the coordinator, you're saying the coordinator is involved in that process and they take the lead with preparing the care plan?‑‑‑Correct, yes, definitely.

***������� NGARI INGLIS�������������������������������������������������������������������������������������������������������������������������� XXN MS RAFTER

PN10516  

Don't answer this if you don't know this but at the time where the coordinator is preparing the care plan and meeting the client, is an environmental or risk assessment of their house, does that take place?‑‑‑Yes, that would be part of the assessment for sure because when we have access to the care plan and we go into the premises, there would be a notification if it's, for example, in a bushfire risk area and things like that.

PN10517  

I note at paragraph 21 you talk about clients that are diabetics and refer to the prick test, so I take it do you � is it common that you would � would you be giving them the glucose monitor to do the prick test themselves, or how would that process be happening?‑‑‑So if we had to do a BGL we would have been trained prior to attending to that client to do the BGL for the client.  Quite often if they've got arthritic hands, et cetera, they're not able to do it.

PN10518  

You would assist them with that and then you look at the reading and I think later in the paragraph you say the care plan tells you what reading would be too high or maybe too low?‑‑‑Yes, it gives you the range.

PN10519  

If it's in either of those red zones, I take it do you call the office to get in touch with an RN?‑‑‑Yes, straightaway.

PN10520  

And you refer to training.  Is that also provided by Resthaven?‑‑‑Yes.

PN10521  

And would that be via the RN, or is that through another person?‑‑‑Usually the RTO comes out.

PN10522  

I'd just like to take you to paragraph 24 of your statement?‑‑‑Yes.

PN10523  

In this paragraph you're referring to an incident where you observed a client � she said she didn't feel well and she had a rash on her face and felt hot, and she ultimately ended up being in hospital that afternoon.  Could you walk me through what you did once you saw the rash and she had told you she didn't feel well?‑‑‑So this particular client � I'm not sure how much we're allowed to talk about the clients, but - - -

PN10524  

You just can't state her name.  Sorry?‑‑‑Okay.  So this particular client's 103 at the time of the statement and lives in her own home.  She has several visits from carers throughout the day, and I had been going to her for a while, and when I got there the T on her face was quite flushed and a bit dry, and this client does have a catheter full‑time.  So she said she didn't feel well, so I just immediately suspected a UTI, and her daughter lives across the road.  So I contacted the office and let them know, and then her daughter across the road � I just knocked on the door and let her know too that mum wasn't well, and they ended up calling an ambulance and she went off to hospital, which I think it turned out to be a USI.  I'd be guessing, but it certainly - - -

***������� NGARI INGLIS�������������������������������������������������������������������������������������������������������������������������� XXN MS RAFTER

PN10525  

Sorry, was it the daughter that called the hospital?‑‑‑Yes.

PN10526  

And when you reported it to the office, what did the office � do you know what happened on their end, or did they tell you what they were going to do?‑‑‑No, I wouldn't like to speculate.  I just gave the information.

PN10527  

No worries, I won't ask you to speculate.  No further questions, Commissioner.

PN10528  

COMMISSIONER O'NEILL:  All right.  Mr Oski, any re‑examination?

PN10529  

MR OSKI:  No questions in re-examination, Commissioner.

PN10530  

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

<THE WITNESS WITHDREW��������������������������������������������������������� [10.15 AM]

PN10531  

COMMISSIONER O'NEILL:  I think next up is Ms Hetherington.

PN10532  

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

PN10533  

COMMISSIONER O'NEILL:  Yes, of course.

PN10534  

MS RAFTER:  Thank you.

PN10535  

COMMISSIONER O'NEILL:  Mr Oski, at the pace we're going we're getting through obviously witnesses beating all land speed records so far, so it might be helpful if you can arrange to give your remaining witnesses advance notice that they may well be called earlier than the scheduled time.

PN10536  

MR OSKI:  Thank you, Commissioner.  Yes, we're in the process of notifying the witnesses accordingly.

PN10537  

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

***������� NGARI INGLIS�������������������������������������������������������������������������������������������������������������������������� XXN MS RAFTER

PN10538  

MS HETHERINGTON:  Yes, I can.

PN10539  

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

PN10540  

MS HETHERINGTON:  It's on, yes.

PN10541  

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

PN10542  

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

PN10543  

MS HETHERINGTON:  My name is Teresa Hetherington.  I am a care worker in Newcastle.  My work address � I don't know, the office is in Warners Bay, NSW.

<TERESA HETHERINGTON, AFFIRMED������������������������������������ [10.17 AM]

EXAMINATION-IN-CHIEF BY MR OSKI������������������������������������� [10.18 AM]

PN10544  

COMMISSIONER O'NEILL:  Mr Oski.

PN10545  

MR OSKI:  Good morning, Ms Hetherington.  My name is Sheldon Oski.  I appear for the UWU today.  Can you just repeat your full name for the record?‑‑‑My name is Teresa Helen Hetherington.

PN10546  

I understand you've made a statement for the purposes of the proceeding.  I believe that statement is dated 19 October 2021?‑‑‑Yes.

PN10547  

And runs to 122 paragraphs over 11 pages.  Do you have a copy of that statement with you?‑‑‑I do indeed.  I have it in front of me now.

PN10548  

Have you had an opportunity to read that again?‑‑‑I have, yes.

PN10549  

It is true and correct to the best of your knowledge and recollection?‑‑‑Well, I have now turned 50, but aside from that, yes.

***������� TERESA HETHERINGTON��������������������������������������������������������������������������������������������������������������� XN MR OSKI

PN10550  

Commissioner, that's at document 250 at page 12208 of the digital court book, and we seek to rely upon that statement.  Ms Hetherington, you're about to see in one of the windows on your screen, there's Mr Ward and he's going to ask you a few questions.

PN10551  

COMMISSIONER O'NEILL:  Mr Ward.

CROSS-EXAMINATION BY MR WARD���������������������������������������� [10.19 AM]

PN10552  

MR WARD:  Thank you, Commissioner.  Ms Hetherington, can you hear me?‑‑‑I can indeed, yes.

PN10553  

I can reassure you I turned 60 last week, so don't stress about turning 50?‑‑‑I'm actually proud of it.  Everything seems to turn better every 10 years, so I'm quite looking forward to 60 myself.

PN10554  

Thank you for the optimism.  Ms Hetherington, my name is Nigel Ward and I appear in these proceedings for the employer interest.  I'm just going to ask you some questions, if I can.  Can I just start, you don't hold a Certificate III, you hold a Certificate IV, is that right?‑‑‑No, I hold a Certificate III in Aged Care.  Does it say I hold a Certificate IV?

PN10555  

Look, I might have written that down wrong in my notes.  Bear with me?‑‑‑Yes, Certificate IV was - - -

PN10556  

Go to paragraph 36, Ms Hetherington.  Can you see that?‑‑‑We're off to a good start, aren't we.  Yes, that says IV.  It's equivalent.  I have not actually gotten the physical Certificate IV, but I am Certificate IV trained.

PN10557  

Bear with me.  So you do hold a Certificate III?‑‑‑I do indeed, yes.

PN10558  

And you're working towards a Certificate IV?‑‑‑Well, I suppose so.  I haven't actually bothered to get the certification, but it's not difficult to get.  My employer does offer those certificates periodically.

PN10559  

Bear with me, I'm just trying to clarify this.  Have you done the Certificate IV program courses?‑‑‑No.

PN10560  

I think what you're saying to me is that you could get recognition for prior learning to get a Certificate IV?‑‑‑That's correct, yes.

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10561  

When did you complete your Certificate III?‑‑‑Roughly 10 to 15 years ago.

PN10562  

So where it says in paragraph 36, 'completed in 2008', was that the Certificate III?‑‑‑That would have been, yes.  I would have checked that one at the time.

PN10563  

Can I just jump back to around paragraph 20?‑‑‑Mm‑hm.

PN10564  

'Carers report to a service coordinator.'  Am I right that you report to a service coordinator?‑‑‑I've had eleven so far and presently do not have one at the moment, but, yes, generally that is the expectation.

PN10565  

And when you say you don't have one at the moment are you telling me you don't report to anybody?‑‑‑I'm telling you that my eleventh service coordinator in the last five years has recently resigned and I at present do not have anyone in that role.

PN10566  

Okay.  So if you need to talk to somebody about something you normally talk to your service coordinator about who do you talk to today?‑‑‑If I'm lucky when I call the office I get assigned to the duty officer who may or may not understand the issue that I'm calling about.

PN10567  

You then refer to a branch manager?‑‑‑Yes.

PN10568  

Do the service coordinators report to the branch manager?‑‑‑That's correct, yes.

PN10569  

And then you talk about allocators.  I take it the allocators are the people who set up your roster.  Is that what they do?‑‑‑That is their job.  They do the allocation of services and they do time keeping as well.  So at the end of the day they check to make sure that each client that we were assigned to, that we performed the length of time that we were assigned to do and that there were no issues within the task time.

PN10570  

In paragraph 11 you talk about having contracted minimum hours of 50 hours, then in paragraph 13 you talk about some fortnights you work up to 76.  Am I right that you've identified to Australian Unity when you're available, and is that when you're offered shifts?‑‑‑Within my availability that is the expectation that the majority of my shifts will be offered, that's correct.

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10571  

I take it the allocators understand that and therefore they're allocating or offering you shifts in those windows?‑‑‑The majority of the time, yes, but I'm a very rare care worker in that I refuse to accept work outside my availability.  The vast majority of care workers find that their availability greatly exceeds their contract obligation.

PN10572  

I am just interested in your evidence.  Your evidence is you only work within your availability?‑‑‑That's correct.

PN10573  

Now, it's not entirely clear to me, is it the service coordinator who prepares the care plan for the client?‑‑‑That's correct, yes.  They do the initial client visit where they're supposed to have a one on one to discuss the client's contracts, the expectation of the job and the client's needs.  They put that down into a documented form which I can then read before I do my first service and it's updated throughout.

PN10574  

Can we just come to the first service.  Do you receive a physical copy of that or is the care plan electronically provided?‑‑‑When it's actually completed it is electronically provided through our work phone.

PN10575  

I take it that if there's to be changes it's the service coordinator who makes the changes to the care plan?‑‑‑They are responsible for that duty, yes.

PN10576  

Can I take you to paragraph 23.  You say in paragraph 23 that you have a greater experience in training complex palliative care?‑‑‑That's correct.

PN10577  

Are you suggesting there that you've got clinical training, or what sort of training have you had?‑‑‑Well, when we have a client that presents with a particular medical diagnosis we are provided training to deal with that particular client and to assist them throughout their transition.  It is often not clinical, but when clinical courses are provided we are given them and often do them.

PN10578  

When you say a client has a particular diagnosis and we're provided training could you give me an example of that?‑‑‑An example of that would be quite recently I had a client with motor neurone disease and we were given the supports as needed, including the basic overall of what motor neurone does to the body prior to accepting those tasks, and supports throughout until his ultimate passing.

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10579  

I take it that that information obviously is useful, but am I right that the support you're providing is still the support within the competencies arising from the Cert III?‑‑‑The Certificate III, no, it would be more in line with at least Certificate IV.  It kind of exceeds that as well often.  Certificate IV is basic community care.

PN10580  

I think what you're saying to me is to do some of that work you need a Certificate IV?‑‑‑Minimum, yes.

PN10581  

Minimum.  You might need a diploma or a nursing degree?‑‑‑Depending on the type of services that we would be providing and the expectation that would come with that.  It's not outside the realm that we would expect a higher level of education for that.  Some of the clients needs are extremely complex and we have been expected to perform those tasks to the best of our abilities or to ask for help if we need it.

PN10582  

Can I just explore that.  Are you saying that you're doing work that a registered nurse might be authorised to do?‑‑‑A registered nurse as in giving injections or PEG feeding and that sort of task?

PN10583  

You seem to be suggesting that it's work beyond that which a care worker would normally give?‑‑‑Yes, that is true.  We are not at medical grade, we don't perform hyperinvasive procedures, but we certainly are performing greater than what is generally expected of a care worker.  Say for example hoist transfers, suction.  A motor neurone client in particular secretes a fair amount of secretions through their mouth and that needs to be removed periodically so they don't choke to death.  Some of us have been trained in that, others were trained watching another care worker perform that task.  Those would generally be assistants.  So we were essentially given that kind of training as we went.  Putting on a uridome that is above the general needs of an average care worker, so we were specifically trained in that.  The PEG feeds, applying and removing of PEG feed tubes, ensuring that the client has everything strapped down where it needs to be so he can be transferred to his care chair.  Even essentially helping him to transfer himself into his shower chair that is slightly above the average needs of a care worker, or the requirement of a care worker.

PN10584  

I just want to go - we will go backwards.  So moving a client into a shower chair you think that's outside of the scope of a care worker?‑‑‑Depending on the grade.  It is above a Grade 2 and it is expected at Grade 3 or Grade 4.

PN10585  

Can I just ask you're not talking now about certification you're talking about the classifications in your enterprise agreement, are you?‑‑‑Those things tend to swing backwards and forwards, so essentially, yes, there are different gradings within the system as well and they all intermingle.

PN10586  

So is what you're trying to tell me this, that there are activities above a Cert III, above a Cert IV competency that your employer requires you to do and trains you to do them?‑‑‑Yes, that is correct.

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10587  

Does your employer ever make a decision that something requires an enrolled nurse or a registered nurse?‑‑‑My employer in particular does actually employ registered and enrolled nurses, so when those are necessary or when the client becomes - their needs become too great for an average care worker they are assigned either access to or transferred over to the nursing staff.

PN10588  

So if there is something clinical in nature the enrolled nurse or the registered nurse gets involved?‑‑‑That's correct.

PN10589  

COMMISSIONER O'NEILL:  Ms Hetherington, you referred to a uridome?‑‑‑Yes.

PN10590  

Can you just explain to me what that is?‑‑‑There are several different types.  The ones that we mostly use it's essentially a condom with a little tube attached to the end.  That is attached to another tube which flows into a bag so that an incontinent client doesn't have to go to the toilet multiple times a day, it's strapped to his legs.  We drain it several times a day to make sure that it doesn't leak and it allows them mobility or at least not having to move as often as they normally would.

PN10591  

Thanks.

PN10592  

MR WARD:  You indicate at paragraph 42 and 76 you were involved in medications?‑‑‑Mm-hm.

PN10593  

Did you do separate training for that?‑‑‑When I started giving medications, no, I did not, but the expectation is that we are only giving medications in a Webster pack anyway, and at specific times as indicated in the care plan, so when the courses are made available they are provided to us.

PN10594  

So, am I right that that's described as medication prompt rather than administering medication?‑‑‑Yes, that's correct.

PN10595  

So you'll tell the client that it's 2 o'clock and it's time for their medications form their Webster pack?‑‑‑When they're able to do it themselves.  Some clients that have dementia or other physical or mental disabilities may not be able to do that themselves, in which case we will retrieve the medications from the Webster pack, put them into a little cup, give them some water and hand it to them, but they must put those items in the mouth themselves.

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10596  

Yes, okay?‑‑‑Or inject or whatever they need to do.

PN10597  

I think you talk about insulin injections in the same way, don't you?‑‑‑Absolutely.

PN10598  

Do I take it that you're not authorised to actually give the injection?‑‑‑Absolutely not.  The courses are offered periodically and if we are attending specific clients in which it may be necessary for us to administer an injection, but generally speaking we are discouraged from performing those tasks.

PN10599  

So what courses teach you to administer an injection?‑‑‑One of the enrolled - one of the nursing staff will come with us to do - to show us how things operate with a client that has minimal - like, sometimes their hands don't work correctly, and they may need us to assist them.  But these are generally done through epipens where you would just measure the dose out and put it in their abdomen, so, they're fairly basic.

PN10600  

Have you done that training?‑‑‑I have not, and I also do not administer and refuse to do so until I have been properly trained.

PN10601  

Is that a reference there to insulin injections?‑‑‑That is.  The majority of medications or injectable medications that we would provide would be those.

PN10602  

Now, I take it at the end of the shift you'll write progress notes?‑‑‑We keep a communication book at each client's house where we document every step of service we have provided.  Any fluctuation or any decline that we notice in the service that we would put in a report which we then provide to our service coordinator via the Procura app, or in DoneSafe, which is a hazard or incident reporting tool within the app.

PN10603  

So, if you were showering a client today, you would write into that book that you've showered them, and I take it if you know there's some exception you'd write it into that book too?‑‑‑That's correct, yes.

PN10604  

I take it that exception that be I might not be as talkative as normal or I might not be eating normally, is that the type of exception you might record?‑‑‑Generally we tend to try to observe the clients, their environment, their mood swings, any decline like if someone has had a mini stroke we are - usually the higher levels are trained to notice any little fluctuations in the client's presentation, so we would document those, yes.

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10605  

And you just said 'higher level's, I take it you're one of the higher level people?‑‑‑I've been in the industry for 20 years under the same employer.  I have taken every opportunity for training and I am on every flipping committee that has ever been implemented, so, yes, I would say that I've got a little bit of an idea how to isolate and target client issues and redirect them where possible.

PN10606  

Don't take this the wrong way, are you the highest level employee they've got?‑‑‑I have not been given the recognition of that, but the expectation is that where possible that I can demonstrate and train others to that level, yes.

PN10607  

So, you hold the view that you are the highest level employee they've got?‑‑‑Look, I'm not that smug, but I certainly do have the skill levels for that title, yes.

PN10608  

That's fine.  Now, I appreciate what you've just said, and you've explained how experienced you are, but let's say you were showering a client and you noticed a tear in their skin, is that reportable event?‑‑‑One hundred per cent.  We are required to report any kind of - that would be considered a deterioration in the client's condition we absolutely must present that to our service coordinator immediately or within 24 hours, and to make sure that the service coordinator follows that up as soon as practicable.

PN10609  

What are other typical reportable events?‑‑‑Client falls.  We have those a lot.  Differences in the client's environment, say if a family member moves in, if they get a pet, if we notice that their equipment is starting to fail, say, they've got a faulty vacuum cleaner, or they require a walker when they don't presently have one, any physical decline within them.  The majority of our clients are quite elderly and frail, often living alone, so we tend to have to keep an eye out for any changes in their conditions, and any equipment or extra services that we would provide that would improve their optimum living conditions.

PN10610  

By reportable event, is that something that you have to report immediately, or is that something you'd put in your progress notes?‑‑‑We are expected to report those both in client notes and as an incident hazard in DoneSafe within 24 hours.

PN10611  

And do you do that through the app or do you do that via an email or ‑ ‑ ‑?‑‑‑Well, because things are quite chaotic, as I stated before, I've had 11 service coordinators in the last five years, and presently have none, I find that the most care workers - the obligation ‑ ‑ ‑

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10612  

I mean to - what happens with you?‑‑‑Yes, I'm just let me finish my answer.  What we generally would do to ensure that the client's incident has been properly recorded and looked at, we do all three at the same time.  We will call the office staff at the time and report it, then we will put an incident in DoneSafe, and make a client note as well.  Some workers will actually exceed that and call the client's family themselves just to make sure that they have been informed as well, because things are so chaotic at the moment, and the turnover is so great there have been repeated instances of clients falling between the cracks.

PN10613  

I take it your employer authorises care workers to call families directly?‑‑‑No, it's generally frowned upon, and if a worker is caught doing it they are spoken to, as it's not actually what we're supposed to do, but they do have a sense of obligation, and a greater relationship with their client, and they feel that they personally need to do that in order to feel that the client's looked after.

PN10614  

So, some of the people break the rules?‑‑‑Yes.

PN10615  

No, that's fine.  I won't ask you if you break the rules, because that might be unfair to you.  When a client is set up to begin with, is there a risk assessment done of the house?‑‑‑Yes.  The client will walk around the house with the service coordinator as they're drawing up the plan and any hazards at the time are logged and catalogued, and any quick fixes or any reparations that can be made before care workers come in are done, and then anything else, as we notice it, then we report it back to the office so it can be fixed.

PN10616  

When you're there you're just, sort of - if you see a hazard you'll identify it and report it.  You're not doing the specific hazard check when you're there?‑‑‑Those are done annually, once a year, the checklists.  But, yes, generally, like, the vacuum cleaner might break this week, but it didn't break three weeks ago, and the service coordinator wouldn't have seen that.  Tripping hazards, like, if someone got a mat for Christmas from their grandchild, that's not going to be in the client notes, but the client just fell over it last week.  So, we tend to try to monitor the environment and look for abnormalities.

PN10617  

As you go?‑‑‑Yes.

PN10618  

If a client is seriously unwell, let's say they were having trouble breathing, is the procedure to call Triple 0 straightaway?‑‑‑No, we are to call our service coordinator first, who checks the notes to make sure that we're authorised to call Triple 0.  We then - the service coordinator will call Triple 0 and we are directed either to stay with the client until ambulance arrives or to move onto the next task if the client is properly supported and able to get where they need to be on their own.

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10619  

Then if you turn up to a residence and you can't raise the client, you can't get through the front door, is there a procedure for that?‑‑‑Absolutely.  We are directed to do the knock and ring and run around the house and check to see if we can see them through a window.  We go to the neighbour's house to see if it's possible they've been out.  Often the client notes will include a relative's phone number.  We can call that or we can call the office and the office staff will then contact the client or the family member to locate them before we move on.  We give them 15 minutes, if they don't respond in that time often we're directed to move onto the next client.

PN10620  

Thank you very much, Ms Hetherington.

PN10621  

COMMISSIONER O'NEILL:  Mr Oski, any re-examination?

PN10622  

MR OSKI:  No questions in re-examination, Commissioner.

PN10623  

COMMISSIONER O'NEILL:  Ms Hetherington, thank you very much for your evidence this morning and you're excused and free to go?‑‑‑Thank you very much.  Thank you for your time, everyone.

<THE WITNESS WITHDREW��������������������������������������������������������� [10.43 AM]

PN10624  

MR OSKI:  Commissioner, I wish to advise that there's been a miscommunication with Mrs Conroy who's unavailable to give evidence today, so we're in the process of seeing if we can reschedule that for tomorrow.  In the meantime we've arranged to move up Ms Goh to appear now if that's amenable to the Commission.

PN10625  

COMMISSIONER O'NEILL:  Of course.  Ms Goh, can you hear me all right?

PN10626  

MS GOH:  Yes, I can.

PN10627  

COMMISSIONER O'NEILL:  It appears we can't quite see you.  Is your camera on?

PN10628  

MS GOH:  I think so.  Let me check.  What about now?

PN10629  

COMMISSIONER O'NEILL:  No, we just see a � it's as if your camera is blocked.

PN10630  

MS GOH:  I've never used this laptop for Zoom.  No, actually, I think I have used it for Zoom so it shouldn't be.  Otherwise it's just that I'm very short and you can't see me.

***������� TERESA HETHERINGTON���������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10631  

COMMISSIONER O'NEILL:  I suspect that's not the problem.  We might press on without the benefit of seeing your face.

PN10632  

MS GOH:  Thank you.

PN10633  

COMMISSIONER O'NEILL:  I'm Commissioner O'Neill and my associate is just going to take you through the oath but can you see everybody all right?

PN10634  

MS GOH:  Yes, I can.  I can see six squares of people.

PN10635  

COMMISSIONER O'NEILL:  Yes, that's all right.  As I said, my associate is just going to take you through the affirmation.

PN10636  

MS ASSOCIATE:  Ms Goh, can you please say your full name and work address?

PN10637  

MS GOH:  Catherine Elizabeth Goh and I work at Brightwater At Home Services in � it's in Currambine, 71 Delamere Street in Currambine but I don't actually work there, I work around the northern suburbs of Perth.

<CATHERINE ELIZABETH GOH, AFFIRMED��������������������������� [10.46 AM]

EXAMINATION-IN-CHIEF BY MR OSKI������������������������������������� [10.46 AM]

PN10638  

COMMISSIONER O'NEILL:  Mr Oski.

PN10639  

MR OSKI:  Thank you, Commissioner.

PN10640  

Good morning, Ms Goh.  My name is Sheldon Oski, I'm appearing for the UWU today.  Can you repeat your full name for the record?‑‑‑Catherine Elizabeth Goh.

PN10641  

I understand you've made a statement for the purposes of the proceedings, is that right?‑‑‑Yes, I have.

PN10642  

Is that statement dated 13 October 2021 and runs to 39 paragraphs over eight pages?  And do you have a copy of that statement with you?‑‑‑I do, yes.

PN10643  

Have you had an opportunity to read through it again?‑‑‑Yes, I have.

***������� CATHERINE ELIZABETH GOH��������������������������������������������������������������������������������������������������������� XN MR OSKI

PN10644  

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

PN10645  

Commissioner, that's at document 240 at page 12,133 of the digital court book and we seek to rely on that statement.

PN10646  

COMMISSIONER O'NEILL:  Yes.

PN10647  

MR OSKI:  Ms Goh, you will be able to see on one of the windows on your screen there's Mr Ward and he will now ask you a couple of questions?‑‑‑Okay.

CROSS-EXAMINATION BY MR WARD���������������������������������������� [10.48 AM]

PN10648  

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

PN10649  

If at any stage you can't just ask me to repeat what I'm asking you if you could.  Ms Goh, my name is Nigel Ward.  I appear in these proceedings for the employer interests and I'm going to ask you some questions.  Do you have your statement in front of you?‑‑‑Yes, I do.

PN10650  

Thank you, Ms Goh.  I see in paragraph 2 that you started life doing a university degree in social work before you moved into home care.  That's correct?‑‑‑That's correct.

PN10651  

I take it, if you look at paragraph 4, you said your job title originally was domestic assistant.  Is that when you were solely doing domestic work?‑‑‑Yes.  I've never solely done domestic work but that was the main focus to start with.

PN10652  

Okay?‑‑‑It's about building skills.

PN10653  

That's okay.  If you go to paragraph 5 you say:

PN10654  

I started out doing domestic work only for the first three years.

PN10655  

Is that correct?‑‑‑Well, where it reads like that what it really means is that over those three years I was gradually building my skills, so it's not quite right but it is.

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10656  

That's all right.  You started doing domestic work and you started around that time as well doing care support work.  Is that what you're saying?‑‑‑Yes, yes.

PN10657  

When you started doing domestic work did you have your certificate 3 at that stage or did you get it later?‑‑‑I got it later.

PN10658  

How much later did you get it?‑‑‑In 2013.

PN10659  

How long had you been doing domestic or care support work before you got your certificate 3?‑‑‑Three years.

PN10660  

Were you required by your employer to have the certificate 3 or did you just want to get it?‑‑‑No, I wasn't required but they offered the training and there was an incentive from the government at that time.

PN10661  

You then in paragraph 7 say you have an associate degree in dementia care.  Do you see that?‑‑‑Yes, I do.

PN10662  

You'll need to help me, Ms Goh, if you could.  I don't know what an associate degree is.  Can you explain what an associate degree is?‑‑‑Yes, the University of Tasmania was offering originally completely free degrees, fully subsidised degrees for people to study dementia to improve the knowledge and skills available because of the lack of skills in aged care.  And so when I started it was for all three years but they changed it and so we had the option to do one year, a diploma.

PN10663  

Yes?‑‑‑Two years, an associate degree;  or three years, a bachelor degree.

PN10664  

An associate degree sits between a diploma and a bachelor's degree?‑‑‑Yes, that's right.

PN10665  

Thank you, that's very helpful.  I take it you use those associate degree skills in your work?‑‑‑Yes, I do.

PN10666  

Which year did you get your associate degree?‑‑‑I think it was '21.

PN10667  

Again, was that just a desire to personally develop or was that something the employer was encouraging?‑‑‑No, that was something I wanted to do.

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10668  

Was that because the Certificate III wasn't sufficient for the work you were doing and you needed more qualification?‑‑‑Yes, it was.

PN10669  

If I could ask you to go to paragraph 13, in paragraph 13 you talk about a variety of training.  I understand that you say you hadn't done much training recently.  The manual handling program, was that an in‑house course run by the employer when it was run?‑‑‑Yes.  Manual handling is mandatory approximately every 12 months to prevent injuries, and to prevent injuries to clients as well, because of the equipment that we use.  That's the primary purpose of it.

PN10670  

Was it a practical course?  Was it hands‑on, or was it an online course?‑‑‑It's now both.  It has a theory component and it's � even though it's called manual handling, it's basically � you know, the range of occupational health and safety things that we need to know about.

PN10671  

How long does it take to do?‑‑‑It's usually about four to six hours, depending on how large the group is.

PN10672  

Then you talk about dysphagia training?‑‑‑Yes.

PN10673  

I take it that that's a topic that would have been covered in your Cert III and possibly your associate degree as well?‑‑‑Yes, but it is a practical mandatory skill because, because it's to prevent people choking, you have to have an understanding of how to monitor people eating and what the right equipment is, and you've got to know about how to mix fluids and consistency of food.

PN10674  

So this was a training course teaching you about the international dysphagia diet standardisation categories of regular, easy to chew, soft and bite‑sized, mixed and moist and pureed; it's about that, is it?‑‑‑That's right, yes.  Yes, it does include that.

PN10675  

How long did that course take to do?‑‑‑I am actually not sure.

PN10676  

If you can't remember it's fine?‑‑‑Yes, I'm not sure.

PN10677  

And then you talk about your medication competency?‑‑‑Mm‑hm.

PN10678  

Again, was that an in‑house course?‑‑‑Yes, that's an in‑house course done with our nursing staff.

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10679  

So that's overseen by a registered nurse, is it?‑‑‑Yes.  Yes, because they hold the responsibility of medication and so they have to be sure that we know how to prevent errors.

PN10680  

I take it that's a little bit of theory and then an actual assessment watching you do things?‑‑‑Yes.

PN10681  

Do you recall how long that one took?‑‑‑I don't think it's a long one.  I think it's perhaps two hours.

PN10682  

In terms of medications, you say in paragraph 22 that 'We also assist with medications'?‑‑‑Mm‑hm.

PN10683  

And you say, 'We mainly are helping with pills from Webster‑paks, but sometimes it's puffers, creams or eye drops'?‑‑‑Yes.

PN10684  

In terms of medications, am I right in saying that you're authorised to prompt medications, but you can't administer?‑‑‑No.  No, some people you have to administer, because � I mean, you don't administer injections, not that kind of thing, but from the Webster‑pak you can prompt people, but there are people that you have to help, because say if a dysphagia, you might have to provide crushed tablets, or put it with yoghurt and put it on a teaspoon.  That's the degree of administration.

PN10685  

Some of your clients you actually feed the medicine to them?‑‑‑Yes.  That's under the instruction of the � often that one's an instruction by the speech therapist.  But generally, as you say, we would prompt people; just take medication out of the Webster‑pak, put it in a cup, give it to them, watch them take it, make sure they haven't dropped anything.

PN10686  

The puffers, creams and eye drops, I take it the puffers are like Ventolin inhalers and steroid inhalers and things like that?‑‑‑Yes.

PN10687  

Are the creams medicated creams?‑‑‑Yes, but we have to have a form signed by a doctor.  For any medication administration there will be a form in the file that says the doctor has authorised it, and we have to check against the cream that they have.  You have to have a rough understanding of � sometimes you have a brand name and sometimes you have a medical name, which can make it confusing.

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10688  

I take it that those things that you've described in paragraph 22, that was part of your training with the registered nurse?‑‑‑Yes.

PN10689  

Now I might just ask you some general questions, if I can?‑‑‑Mm‑hm.

PN10690  

Who do you report to � who's the person you report in to in the business?  What title do they have?‑‑‑We have two team leaders � no, sorry, three - three, but one in our south region and two in our north region, and we're usually allocated one, but we can ask either of them.

PN10691  

Do you know if the team leaders have any particular qualification?  Are they registered nurses or not?‑‑‑No.  They're � I'm just trying to think � I think that they are trained in occupational health and safety, and there's the Cert IV in Training and they have � one came from residential care, and the other has been trained as an occupational therapy assistant and a support worker.

PN10692  

I take it that you have procedures where you have to contact the team leader about things?‑‑‑Yes, that's right.

PN10693  

Can I just go through some examples if the way you operate is similar to other people?  If you were showering a client and you noticed they had a tear in their skin, is that something that's reported to the team leader?‑‑‑No.  That one would be reported to the coordinator.

PN10694  

Bear with me, can you describe for me the difference between the team leader and the coordinator?‑‑‑The coordinator is there to look after client issues.  The team leader is there to look after issues that � say, if I didn't know what to do, I would ask the team leader and then she would direct me.  But if I just noticed a problem with a client, I would report that to the client coordinator, because I know that a skin tear is a problem.

PN10695  

And the coordinators, do they have any particular qualification?‑‑‑Some of them are enrolled nurses, some of them are social workers � I'm just trying to think.  Some of them have been support workers; some have allied health.  So it's a bit of a variety.

PN10696  

So if you noticed a client was losing weight, is that something you'd report to the coordinator?‑‑‑Yes.

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10697  

I take it at the end of your visit with the client, you'll write some progress notes for the client?‑‑‑Yes.  If there's anything unusual, you put it in the progress notes.

PN10698  

Bear with me, how I describe this � if you were simply showering the client and nothing unusual happened, would you write that in the progress notes?‑‑‑No, you just document that you've been, because it's assumed that you � it's just assumed that you followed the care plan.  You don't need to note it, because otherwise you'd have hundreds and hundreds of pages of 'client had a shower today.'  Some clients are reluctant to shower, so it's really important to document that they did have a shower or didn't have a shower, but when it's just a standard � like, if everything goes to plan, you don't have to document that.

PN10699  

So you're documenting what we might describe as the exception?‑‑‑Yes.

PN10700  

Let's say in the case of the skin tear, you would document it and contact the coordinator?‑‑‑Yes.

PN10701  

And is it the coordinator's job then to determine how to proceed after that?‑‑‑Yes.  The coordinator will usually let the clinical staff know and refer � make a referral for them to go and check and do some wound care.

PN10702  

I take it then that Brightwater employ their own enrolled nurses and registered nurses?‑‑‑Yes, they do.

PN10703  

If it's a clinical activity I think you've just said those people would be referred in to actually deal with the client's issue?‑‑‑Yes.

PN10704  

If it's more serious than that and let's say that the client was having serious trouble breathing, what's the procedure you'd follow then?‑‑‑I would � no, it's a little bit � it depends on the emergency.  If it's critical I'll call the ambulance straight away and then call the coordinator.  If it's � if I'm not sure, I'll call the coordinator and they'll direct me to call an ambulance and contact the family.

PN10705  

And does the - - -?‑‑‑Well, I wouldn't contact the family;  the coordinator would.

PN10706  

The coordinator would contact the family, yes?‑‑‑Yes.

PN10707  

Yes and am I right in saying it's the coordinator who writes the care plan?‑‑‑Yes.

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10708  

How do you receive the care plan?  Do you receive a written copy or an electronic copy?‑‑‑No, at the moment we have a file in the client's house that, yes, that usually they'll keep it up on their fridge or somewhere near the front door so that we can find it but sometimes we have to play 'hunt the file'.

PN10709  

Essentially there's a copy of the care plan in the client's house?‑‑‑Yes.

PN10710  

Hopefully somewhere you can find it?‑‑‑Yes.

PN10711  

I take it is that where you also � do you also use that file to write your progress notes at the end of the client's visit?‑‑‑Yes, it's the same file.

PN10712  

The same file.  Does the coordinator do an initial risk assessment of the house to make sure it's safe to go into?‑‑‑They are supposed to.

PN10713  

I take it by that, that you're a little sceptical and sometimes they might not?‑‑‑Yes, that's right.

PN10714  

But they're meant to do that, are they?‑‑‑Yes.

PN10715  

Are you informed as to the outcome of that risk assessment or is that something that's done separate to you?‑‑‑Often it's in the file, so it's � when I say that, you would, you know, probably find that if it's a new client they have that done but sometimes if coordinators change and the circumstances have changed, it may not be.

PN10716  

Are you required to identify hazards in the home if you observe them?‑‑‑Yes, we are.

PN10717  

Does that go to the team leader or the coordinator?‑‑‑That would probably go to the � depending on whether it's a hazard for the client or a hazard for the worker, so - - -

PN10718  

If it's a hazard for you would it go to the team leader?‑‑‑Yes, yes, yes.  If I trip over a step and I think it's broken and the client doesn't really come out, I would let the team leader know that it's dangerous for workers, you know.  If you're there at night you might have a fall.  If the client was falling down their steps, you know, then I would definitely let the coordinator know because it's affecting them.  Often it's things like loose mats that you have to be aware of.

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10719  

I take it if it's a client issue the coordinator will engage with the client?‑‑‑Yes, the client or their family.

PN10720  

Does the team leader do the same on your behalf as well?‑‑‑No, I think the team leader would � yes, the team leader would have a discussion with the coordinator that something needs to be fixed and she would organise it with the - - -

PN10721  

They would take care of making sure it's fixed?‑‑‑Yes.

PN10722  

Have you ever personally felt unsafe with a client?‑‑‑Yes.

PN10723  

Is there a procedure that you're required to follow if you are feeling unsafe?‑‑‑Yes.  If you're feeling unsafe you can � and the client is safe, you can actually just leave and let the office know that you weren't able to stay in the service.

PN10724  

I take it that that might relate to the client's behaviour but it also might relate to something that's going on in the house?‑‑‑Yes, it could be.  It could be that the client is smoking and the worker, they're not supposed to smoke around us.  Sometimes it's something like that or sometimes it's aggression or sometimes it's sexual comments.

PN10725  

I take that you report those back to the coordinator and the coordinator deals with them?‑‑‑Yes.

PN10726  

Have you personally had to leave a house?‑‑‑Yes.

PN10727  

Recently?‑‑‑Not for a while, no.

PN10728  

Is not for a while a few years or - - -?‑‑‑I'm trying to think when it � yes, a couple of years.  It's a couple of years since I had that.  I think I'm very good at communication.

PN10729  

You're very good at de-escalating?‑‑‑Yes.

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10730  

I'm just interested because I haven't seen one of these before.  What skills did the associate degree in dementia give you that the certificate 3 didn't give you?‑‑‑Well, that's very hard to explain.  It's a level of � I suppose it would cover psychology, biology, health issues, understanding of the different types of dementia and cognitive decline, how it affects behaviour.  There's really a whole � it's a whole another level of understanding how people function and communication, and I think it just makes you feel a bit more confident having that behind you.

PN10731  

I take it what you've just described is it's broader in scope and deeper in knowledge compared to the cert 3?‑‑‑Yes, yes, and it also applies to � even though it's dementia care it does apply to aged care in general, not just dementia care.

PN10732  

There's a variety of skills that you learnt in the associate degree that have broader application?‑‑‑Yes.

PN10733  

Could you give me an example?‑‑‑Well, one of the units I did was in understanding people's right in dementia care.

PN10734  

Yes?‑‑‑Understanding where the line is, where their decision-making starts and finishes and where families have a right to say, you know, where there's guardianship issues, that kind of thing.

PN10735  

I take it, it's made you more competent and more confident?‑‑‑Yes.

PN10736  

Ms Goh, thank you very much for your answers.  Commissioner, we have no further questions.

PN10737  

COMMISSIONER O'NEILL:  Mr Oski, any re-examination?

PN10738  

MR OSKI:  No re-examination, Commissioner.

PN10739  

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

<THE WITNESS WITHDREW��������������������������������������������������������� [11.10 AM]

***������� CATHERINE ELIZABETH GOH���������������������������������������������������������������������������������������������������� XXN MR WARD

PN10740  

COMMISSIONER O'NEILL:  This might be a good time to take a short break but just before we do can I just raise one matter for the Union representatives:  can you indicate after the break when there will be an updated hearing plan for the employer witnesses to be dealt with tomorrow and Thursday, please.  I'm conscious of the discussion the other day where 13 hours was referred to and there was a question about how would be doing what.  If you can indicate when that will be provided after the break and we will resume at 11.30.  The Commission is adjourned.

SHORT ADJOURNMENT������������������������������������������������������������������ [11.11 AM]

RESUMED�������������������������������������������������������������������������������������������� [11.30 AM]

PN10741  

COMMISSIONER O'NEILL:  All right, the Commission is resumed.  Is there anyone that can update me on when the hearing plan will be filed?

PN10742  

MR GIBIAN:  Yes, Commissioner.  Sorry, it's Mark Gibian, if you can hear me.  We have had a discussion with Mr McKenna and Mr Hartley essentially about timing and whose going to go first with cross-examining each of the witnesses, and then were provided this morning, having communicated estimates to Mr Ward, have been provided with a proposed order from Mr Ward earlier this morning, or in the course of this morning which has two witnesses on Wednesday afternoon and the remainder throughout the day on Thursday.

PN10743  

I think the only suggestion I was going to make out of that was maybe that if it doesn't cause great inconvenience it may be advisable to have another witness available on Wednesday afternoon, in case they are reached, to avoid too much of a crush on Thursday, but that was the only suggestion I was going to make.  I don't think we have communicated that to Mr Ward yet, he's been sitting in the hearing obviously, but that was the only suggestion I had in relation to that, otherwise the order of the witnesses is a matter for Mr Ward and his clients obviously.

PN10744  

COMMISSIONER O'NEILL:  Mr Ward?

PN10745  

MR WARD:  Well, Mr Gibian is right, it's the first I have heard of it, but that's fine.  I will one of my people make some enquiries now to see if we can have a third on stand-by in the afternoon, that's fine.

PN10746  

COMMISSIONER O'NEILL:  So I am just looking to see when you're going to file the actual list of the order.

PN10747  

MR OSKI:  I'm sorry, I was on mute.  I mean, we can certainly provide the proposed order that we received from Mr Ward now or immediately subject to the one matter I mentioned, and that's just for the abundance of caution so that we don't have any time that's wasted on Wednesday, if that comes to pass.

PN10748  

MR WARD:  Commissioner, if I could just have a moment, Ms Lombardelli's dealing with that.  I understand we're endeavouring to get it to you by 12 o'clock.  If I could just have a moment to withdraw and quickly talk to her, I'm sure I can sort that out in the next minute?

PN10749  

COMMISSIONER O'NEILL:  Yes, please do.

PN10750  

MR WARD:  Thank you, Commissioner.

PN10751  

MR McKENNA:  And, Commissioner, while Mr Ward does that, I'd just echo what Mr Gibian has said.  My instructing solicitors actually have written to Ward, no doubt he has other things happening at the moment, but a short time ago suggesting precisely what Mr Gibian has raised, and perhaps if there is to be someone on standby it might be one of the witnesses who's estimated to take less time.

PN10752  

COMMISSIONER O'NEILL:  All right.

PN10753  

MR WARD:  The benefits of an electronic hearing, I think.  Commissioner, we've sent the revised list back to the unions, as I understand it, and subject to any comment from them, which we would presume there probably isn't going to be any further comment, we'll forward that to the Commission by 12 o'clock today.

PN10754  

Can I indicate that we're going to make inquiries to see if Ms Sue Cudmore could be available for Wednesday if we need a pinch hitter to come on in the afternoon.

PN10755  

COMMISSIONER O'NEILL:  Okay.

PN10756  

MR WARD:  And subject to hearing back from Ms Cudmore, I'll be able to confirm that before the close of business today.

PN10757  

COMMISSIONER O'NEILL:  Thank you very much.  Mr Oski, is it Ms Moffat next?

PN10758  

MR OSKI:  No, because Ms Moffat cannot do any earlier than midday, so we propose to bring forward, Ms Morton from 12.30 to now.  I believe she's on the line.

PN10759  

COMMISSIONER O'NEILL:  All right, and she's ready to be admitted?  All right.

PN10760  

Ms Morton, can you hear me all right?  Ms Morton, can you hear me?

PN10761  

MS MORTON:  Yes, I can hear you.

PN10762  

COMMISSIONER O'NEILL:  Lovely.  Are you able to turn your camera on at all?

PN10763  

MS MORTON:  Yes, I can.

PN10764  

COMMISSIONER O'NEILL:  Lovely.  All right, well, Ms Morton, I'm Commissioner O'Neill, and my associate is just going to have you take the affirmation.

PN10765  

MS MORTON:  Okay.

PN10766  

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

PN10767  

MS MORTON:  My name is Susan Mary Morton, and my work address is in Penrith.

<SUSAN MARY MORTON, AFFIRMED���������������������������������������� [11.35 AM]

EXAMINATION-IN-CHIEF BY MS OSKI�������������������������������������� [11.36 AM]

PN10768  

COMMISSIONER O'NEILL:  Mr Oski.

PN10769  

MR OSKI:  Good morning, Ms Morton.  I'm Sheldon Oski.  I appear for the UWU today?‑‑‑Good ‑ ‑ ‑

PN10770  

Can you repeat your full name for the record?‑‑‑Good morning.  Yes, Susan Mary Morton.

PN10771  

Thank you.  I understand you've made a statement for the purpose of the proceedings; is that correct?‑‑‑Yes, I have.

PN10772  

That statement is dated 27 October 2021 and runs to 47 paragraphs over six pages?‑‑‑Yes.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������������ XN MS OSKI

PN10773  

Do you have a copy of that statement with you?‑‑‑Yes, I do.  Yes.

PN10774  

Perfect.  Have you had an opportunity to read through it again?‑‑‑I did, but I don't retain everything that I've written down of course.

PN10775  

Not a problem?‑‑‑Yes, it's true and correct.  Yes.

PN10776  

Commissioner, that's at document 248 at page 12190 of the digital court book, and we seek to rely upon that statement.

PN10777  

Now, Ms Morton, you'll be able to see on one of the windows on your screen Mr Nigel Ward.  He will now ask you a few questions?‑‑‑Hi Nigel.  Yes.

CROSS-EXAMINATION BY MR WARD���������������������������������������� [11.37 AM]

PN10778  

MR WARD:  Ms Morton, how are you, good morning?‑‑‑Good morning.

PN10779  

My name is Nigel Ward.  I appear in these proceedings for the employer interests, and I'm just going to ask you a few questions.  Do you have a copy of your statement in front of you?‑‑‑Yes, I do.  Yes.

PN10780  

Lovely.  Can I just start with your title?  You're described as an advanced care worker.  Is that a senior care worker in your organisation?‑‑‑Yes, that's what we used to call a grade 3.  So, we would do complex care as in especially, like, looking after the customer, more like bowel care and those sorts of procedures.

PN10781  

So, in your organisation there's a less qualified or experienced care worker underneath that grade?‑‑‑Yes, we go through to grade 4, but that's only if you're a mentor or a trainer.  I was that at one stage, but I'm not now, but, yes, a grade 3 is the highest you can go in the field.

PN10782  

In the field, okay.  Okay?‑‑‑Yes.

PN10783  

And you say in paragraph 4 that you trained at business college and to be a nurse.  Am I right that you didn't finish your nursing?‑‑‑Yes, because I couldn't give needles.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10784  

Yes, I'm with you on that.  And did you ultimately get qualifications in care work or not?‑‑‑Yes, well, we do - they put us through, you know, like certificate - you know, certificate in aged and disability, you know, III and IV.  But, you know, through when we were called home care that's when, you know, I was a mentor and a trainer and got that sort of - yes, that sort of qualifications, yes.

PN10785  

So just bear with me.  So, I just struggle to see it, do you have a certificate III in ‑ ‑ ‑?‑‑‑Aged and community care, I think it is.

PN10786  

Okay?‑‑‑Yes.

PN10787  

Do you have a certificate IV as well?‑‑‑I don't think when I was doing it that there was a IV.

PN10788  

Right.  But you have a three?‑‑‑Yes, I'm pretty sure.

PN10789  

That's okay.  No, that's fine?‑‑‑You're really testing my brain, aren't you?

PN10790  

It was a while ago, was it?‑‑‑Absolutely.  And when you become an old fart, you know, the brain doesn't work much any more.

PN10791  

Excellent.  Could I just talk a little bit about structure at Australian Unity?  If you to go to paragraph 5 you talk about a number of different roles?‑‑‑Yes.

PN10792  

The first role you talk about is a service coordinator.  Is the service coordinator the person who supervises you?‑‑‑Yes.  Yes, she's supervises.  And she's the one who goes out and talks to the customer and puts the care plans into place, and, you know, sets the ball rolling.  And we answer to the service co, yes.

PN10793  

And I take it the allocators, they're the people who build your roster, are they?‑‑‑Yes, they are.  Yes, they are.

PN10794  

So, if you're upset with the roster, they're the people who did it?‑‑‑Well, I generally go for the throat for both of them, but anyway.

PN10795  

Can I ask you some general questions, then I'll possibly come back to your statement.  So, the service coordinators do the care plan?‑‑‑Yes.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10796  

And how are you provided the care plan?‑‑‑Well, on this phone that, you know, we all dread because we never used to do them, and we go to our (indistinct) the phone and go to your roster, you click on the person that you're going to work with today, and then there's a care plan, you know, on the screen, and you just hope that it is there, and it is up-to-date, and it is correct, because sometimes ‑ ‑ ‑

PN10797  

So, you access it on the app, I take it?‑‑‑Yes.  Yes, Procura, I think is the company.

PN10798  

Procura?‑‑‑Is the app that we use.  Yes.

PN10799  

I take it that sometimes you're concerned that it might not actually be where it's meant to be?‑‑‑Well, sometimes it is because as you realise when we're dealing with the oldies, because they've split us now, we don't do disabled any more, we do the oldies, and their dailies needs changes, and they also deteriorate, and if you haven't been - you know, if they only get - maybe they might only get a weekly - or not so much weekly, but they -I mean, sometimes they get three times a week showers, so, you know, things can happen, you know, in each day, so you just hope that everything is up-to-date when you go there.

PN10800  

I see.  And when you finished your visit with a client ‑ ‑ ‑?‑‑‑Yes.

PN10801  

‑ ‑ ‑ I take it you record your progress notes somewhere?‑‑‑Yes, we do, and that's a bone of contention, because we're finding that the more and more that it's happening we're not being paid for any of this stuff, and so AU are telling us that we're supposed to do it in the customer's home, and how you can do - read a care plan, in a half an hour, if it is a half an hour shower, read the care plan, give somebody a shower and give them all the TLC you need to do.

PN10802  

Yes?‑‑‑And then also write something as well.  That's, you know, and they're saying doing it in their time.  Well, it doesn't really � in the real world that doesn't happen.

PN10803  

That's okay but - - -?‑‑‑We do a lot of unpaid work.

PN10804  

Well, that's why you're probably a member of a union?‑‑‑Yes.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10805  

Can I ask, though, where are the progress notes written?  Are they written in a book in the client's house?‑‑‑Generally, no.  They keep it all on that � in that same (indistinct) and actually when you click and flick all this rubbish and it says, 'Write notes.  Create a note.'  And you actually go in there and you write what happened for the day, you know, if there was � you'll always have to write something.  You know, whether you've just given them, you know, an assisted shower and, you know, do the care plan, you know, put their Sorbolene and stuff on.  But if something you feel is not right, you know, with the customer, you would note it but also if it's bad enough, you know, then you would actually be doing it in a DoneSafe � which we call a hazard or an incident.  But if I think it's bad enough I just ring the coordinator and say, 'Hey, you know, we better get something sorted.'

PN10806  

Just help me out there.  We might do this slowly?‑‑‑Yes.

PN10807  

What is DoneSafe?‑‑‑DoneSafe is another app on this phone of ours where we click into and that's where we fill a hazard in, and a hazard has something that has potential to harm somebody.  So and if that's � yes, so we fill a hazard in and that � and we've got to do that within � that's a reporting mechanism we must do within 24 hours.  Or if there's something that it's not actually a hazard that's going to be a harming thing but there's an incident that, you know, you just feel � you might think that that needs to be recorded, we have the incident and that's in DoneSafe as well.

PN10808  

Is that an incident with the client or is that an incident - - -?‑‑‑Yes, yes, a bit of both.  You know, whether it was something with the family or it might even be the house, if there was some small incident that could happen, you would put that on an incident form as well.

PN10809  

You said if it was more serious you'd ring the service coordinator directly?‑‑‑If I'm really concerned, yes, I would be.  I would be saying, 'We need to get the nurse out there.'  You know, if it was like a bedsore that I'd seen deteriorating and then I would actually, you know, I don't know � I don't care whether they like it or not but they normally hear from me if I, you know, if I think they need to hear.

PN10810  

If you were showering me this morning and you saw a bruising or you saw a bedsore or you saw a tear in my skin, you would probably go straight to the coordinator?‑‑‑Well, I would be telling her that we � you see, it also depends on, you know, the household.  I mean, if your wife is there and she looks after you lovingly and she's the one that's going to, you know, do something, well, then you bring it to her attention but you would actually fill in an incident form to say that's there, you know, and you've told the wife.  But, you know, like, if � and, I mean, as they get older too some of them are capable of doing things and some of them aren't.

PN10811  

Okay?‑‑‑Yes, so it just depends.  Each one's needs has to be dealt with different.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10812  

I take it that Australian Unity employ their own nurses, do they?‑‑‑Yes, they do, yes.

PN10813  

And is - - -?‑‑‑Apparently � sorry, what?

PN10814  

No, go on.  You talk?‑‑‑No, I was going to say, apparently now the dear government that we have, when they have this package they have to � the nursing has to come out of their package so that they're not double-dipping and going to the community nurse.  So if you didn't have a package you'd ring the community nurse and they would come out, but if you've got a package, well, then the nurse's fee comes out of your package and that isn't cheap, I can tell you now.

PN10815  

No, that's okay but let's say you noticed I a tear in my skin, you might contact the service coordinator and the service coordinator would then contact the registered nurse?‑‑‑Yes.

PN10816  

The registered nurse would go and deal with the clinical issue?‑‑‑Yes, yes but bear in mind, you know, they sort of � their � they've got a big area to cover so they wouldn't be able to go out at the drop of a hat.  Everything has sort of got to, you know, take it into what area they are.  I don't know how many nurses we've got on board but, yes, so they have to work out to get there.  But if it's an emergency type situation, often a nurse might go out of area, you know, to go and deal with that, you know, with � I had one recently where I was gobsmacked because I was off with COVID and when I come back I couldn't believe this bedsore this man had, how bad it got, so the nurse actually got out there that very afternoon which was great to deal with.

PN10817  

Straight away?‑‑‑Yes.

PN10818  

If it is an emergency situation and you can't get hold of a nurse, is the protocol to ring Triple 0?‑‑‑If it was, like, life-threatening, yes, but to deal with a bedsore like that, no.  We would probably get asked, you know, the wife, you know, what she's got there and she may even just apply some sort of lotion or potion until the nurse, you know, gets there.  But it would only be life-threatening situations that we would be calling the, you know, the ambos.

PN10819  

If I was seriously short of breath or something like that, that might be a Triple 0?‑‑‑Absolutely, yes, or if you had a fall.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10820  

Yes?‑‑‑We're not allowed to pick you guys up so, you know, we would be calling the ambos to come out and assess the situation and, you know, and then see what's going to happen.

PN10821  

Do you ring Triple 0 yourself or do you ring the service coordinator to ring Triple 0?‑‑‑No, we would � it's getting harder and harder to get these guys to answer the phone.  We would be ringing Triple 0 or, as I said, if the wife was there or the husband or whatever, they - - -

PN10822  

They would?‑‑‑ - - - ring Triple 0 while we're there with them, you know, like, and work that way.  And we normally stay there until the ambos come to see, you know, what's going to happen and so forth.

PN10823  

In paragraph 19 you talk about medication?‑‑‑Yes, yes, yes.

PN10824  

Am I right that you did extra training to do medications?‑‑‑Yes, this wonderful company we work for did bring in a trained nurse and take us in � you know, we actually sat in a group session and they run through the medication, you know, the procedures, you know, about giving out medication and how you give it and what you're supposed to do and so forth.

PN10825  

In terms of tablets, do you understand that to be Schedule 4 medications, not Schedule 8?‑‑‑Yes, well, we're only allowed to give tablets that are in a blister pack.

PN10826  

Right?‑‑‑Say, for instance, your wife, you know, doses up your little dosette boxes and puts all the tablets in the plastic one, she wants to get rid of you for the day.  You know, well, then she'd say, 'Okay, Sue, you know, give these to him today.'  We're not allowed to give anything out in a dosette box, you know, those little plastic ones.

PN10827  

Yes?‑‑‑We can only give something which is in a blister pack which the chemist has, you know, filled in and that hasn't been tampered with.  You know, you've got to push out like a little cellophane and alfoil pack which you actually push through and, yes, and that's the only sort of medication that we're allowed to give out.

PN10828  

In terms of giving it out, just bear with me in terms of how I describe this.  I think the term is medication prompt?‑‑‑Yes, yes.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10829  

You don't actually administer the pills to the person?‑‑‑Well, depending on, you know, whether they're paras or quads or, you know, they've got arthritis or something.  We may have to use that little � empty the, you know, the pack into maybe a little medicine cup or something and give it to them.  That's if they can't get it out themselves.

PN10830  

You talked about paraplegic and quadriplegic, is that a reference to when you were doing disability care?‑‑‑Yes, see, over 65 if they became a � you know, before the NDIS came into effect, you know, if they � well, under 65 the NDIS look after them.  So if somebody is already over 65 and they are a paraplegic or a quadriplegic, well, they would � you know, the aged care look after them.

PN10831  

Right?‑‑‑But sometimes that's due to maybe MS, multiple sclerosis so, therefore, you know, they are confined to the bed or paralysed down one side.  And so, yes, you know, that's when I � but mainly, as I said, NDIS would do the paras and the quads.

PN10832  

Am I right in saying you used to do both disability work and aged care work?‑‑‑Absolutely and I loved it because we had a mixture of both and so then when Australian Unity and their wonderful system decided to split us, you got a choice of who you wanted to work with but because I'm an old fart now I thought, no, they'll burn me out, disability, so I stayed with my oldies.  But I love them to death anyway, my oldies.

PN10833  

In addition to the Webster pack pills, you do eye drops and ear drops.  Again, they're medicated eye drops and ear drops?‑‑‑Yes and that was also in part of the training as well where, you know, you're washing your hands and you've got gloves and you need to check the date on the pack and also, you know, what they are and then, you know � you know, so if you're going to give eye drops or ear drops, yes, you know, you have to follow protocol there as well.

PN10834  

I take it when you did the training the nurse assessed you and signed you off as being competent?‑‑‑Yes, yes, she did.

PN10835  

I think you said earlier the service coordinator is writing the care plan.  I think that was right, wasn't it?‑‑‑Yes, yes.

PN10836  

Do they go out and do a risk assessment of the home to make sure it's safe as part of setting up a client?‑‑‑Yes, they do, they do, and I think what we find is the service co who either were care workers or had nursing backgrounds are far better at assessing and writing care plans than, you know, just the - and we're finding that more and more now that we're getting service co's that are coming, you know, from other organisations, you know, not necessarily a caring background.  You know, we've had some come from, you know, working in finance and all these sorts of things.  They don't - they're not as experienced, you know, assessing clients and writing care plans as what, you know, the people that have already had that experience either in the field or have been nurses.  You can see the difference when they write their care plans.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10837  

You're concerned about the quality of some care plans?‑‑‑Absolutely.  Absolutely.

PN10838  

In terms of doing the risk assessment I take it that's to make sure that when you attend the residence it's safe?‑‑‑Yes.  Yes, it is, yes.

PN10839  

When you go yourself do you do any mini risk assessment along the way or do you report any hazards, is that part of the process as well?‑‑‑Yes, yes.  You know, you've got to  have your eyes and ears open at all times as I said, you know, going in and checking, because sometimes if a customer knows that a coordinator's coming sometimes they can be a bit cheeky, you know, and have the good vacuum cleaner sitting there, you know, and when we get there they don't want you to use that one or there could be cords across, you know, the hallway, or there's a heater in the shower that they want you to put on, you know, when you're giving them a shower, and the coordinator may not see any of that sort of stuff.  It's us care workers, the hands on guys, that pick up a lot more.

PN10840  

I just want to understand a few things if I can.  Can I just take you to paragraph 21?‑‑‑Yes.

PN10841  

Is that a story about you or is that a story about somebody else?‑‑‑No, it's someone else.  I hear about it, because I'm a sticky beak and I hear - I talk to everybody.

PN10842  

No, that's okay, I just wanted to understand.  Then at 25 you say, 'I recall earlier in my employment that carers would carry a receipt book.'  Are you talking there about the 1980s or what - - -?‑‑‑Absolutely.  Yes, I started - I started 34 years ago, and when I first started we actually had a book that we would take the money and we would - you know, and give the customer a receipt, and then at the end of the week we'd go to the office and give the receipts, but we kept the money and so then that was taken out of our wage, the money that you kept, you know, that you got from the customer, and the customers loved that because they didn't have to go anywhere.  You know, now they've got to go to banks, or now we try and do all this electronic stuff now anyway, but that was the good old days.

PN10843  

I remember them well.  In paragraph 33 you're talking about your notes there.  Are those the notes you told me earlier on you put into the app?‑‑‑Yes.  Yes, and Procura, yes.  And of course, you know, like we've got care workers and we've got cowboys as I call them, and so it depends on, you know, what sort of notes they put in.  Some people, you know, forget to do it.  I mean, I know we're supposed to do them, sometimes girls - well, I think maybe they forget or they run out of time, but every customer we are supposed to do a customer note.  You know, every customer we do we've got to report something.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10844  

Okay.  If I can take you to paragraph 11 in light of that comment.  You say in paragraph 11, 'In my experience new starters do not receive adequate training to work in the field'?‑‑‑Yes.

PN10845  

Do your new starters all have Certificate IIIs now?‑‑‑They are putting them through it, but because they're always looking to put bums on seats straight away sometimes they're actually taken out, you know, and given like a buddy and they can go out and work with their buddy and, you know, so got to have their manual handling, and then they want them out in the field as quick as they can because, you know, we are so short staffed, and then what happens is they do a Certificate III like a registered training course and they have to do it in their own time, and with COVID I know it's been hard, because they used to come to the office one day, I don't know, it was a month I think, to do some of their work, you know, with a trainer, but now nearly all of it's online.

PN10846  

Do you have new starters who have a Certificate III?‑‑‑I think there's probably some of them that have, but - - -

PN10847  

Do you work with them?‑‑‑Not a lot, because most of our jobs - you know, you're out on your own, you know, you sort of live your own world, you're out there doing customers and you don't - you could go all week and never see another care worker.  You could go for a month and not even see another care worker.

PN10848  

When you talk about these new starters you haven't personally worked alongside them?‑‑‑Not unless they come out for buddy training with me, but because I do a lot of complex work sometimes they don't really want me to take them out to see some of the complex stuff, but will take them out with some of the other girls that are doing more simple stuff, because, you know, that's what they're going to be doing when they first start.

PN10849  

I take it by complex work you don't mean you do clinical work?‑‑‑What do you call clinical?

PN10850  

Well, work that would require a scope of practice of an enrolled nurse or a registered nurse?‑‑‑No.  No.

PN10851  

So your work is care work and it's within the scope of your Certificate III?‑‑‑Yes.  Yes.  Because as I said some of our customers as they deteriorate (audio malfunction) one day a week.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10852  

COMMISSIONER O'NEILL:  Ms Morton, we just had a bad line there so we didn't hear clearly your answer to that question?‑‑‑Sorry.  Yes, so what I was just referring to - can you hear me now?

PN10853  

Yes?‑‑‑Yes.  A lady that has multiple sclerosis, and she's had it - she's in her 70s, she's had it since she was early 30s, and so now she's confined to bed, she can't walk and she's paralysed down one side.  So those sort of customers we wouldn't - well, we hope not to, to be sending our new staffers to, because it is complex, you know, doing a bed bath and somebody that's paralysed and, you know, you're rolling them, changing their clothes, putting clean sheets on the bed and all that sort of stuff.  That wouldn't - well, occasionally they do a bit of a slip up and they may send new staff in because they're looking for bums on seats, but that - you know, hopefully that doesn't happen.

PN10854  

MR WARD:  I take it your deep experience dealing with people with disabilities would come into play there?‑‑‑Absolutely.  Absolutely, yes.

PN10855  

Thank you, Ms Morton.  No further questions, Commissioner.

PN10856  

THE WITNESS:  Thank you.

PN10857  

COMMISSIONER O'NEILL:  Just a minute, Ms Morton.  Any re-examination, Mr Oski?

PN10858  

MR OSKI:  No questions in re-examination, Commissioner.

PN10859  

COMMISSIONER O'NEILL:  All right.  Ms Morton, thank you for your evidence today and you're excused and free to go?‑‑‑Okay.  Thank you so much.  Thank you for listening.  Thank you, bye.

<THE WITNESS WITHDREW���������������������������������������������������������� [12.00 PM]

PN10860  

COMMISSIONER O'NEILL:  I think we have Ms Moffat ready to join.  Ms Moffat, can you hear me all right?

PN10861  

MS MOFFAT:  Yes, I can.

PN10862  

COMMISSIONER O'NEILL:  All right.  Would you be able to turn your camera on if you can.

***������� SUSAN MARY MORTON������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10863  

MS MOFFAT:  It's on.  There we go.

PN10864  

COMMISSIONER O'NEILL:  We can't see you.  Perhaps give it another go.  Ms Moffat, any luck with that?

PN10865  

MS MOFFAT:  I can see (audio malfunction) and my camera states that I'm on - in my camera I'm right down the bottom, so I don't know what - - -

PN10866  

MR GIBIAN:  We can see Ms Moffat if it's any assistance.

PN10867  

COMMISSIONER O'NEILL:  Can you?

PN10868  

MR GIBIAN:  Yes.

PN10869  

COMMISSIONER O'NEILL:  All right.  Maybe it's a problem at my end.

PN10870  

MR WARD:  I can't see - - -

PN10871  

COMMISSIONER O'NEILL:  Can you see Ms Moffat?

PN10872  

MR OSKI:  I can't see Ms Moffat either, Commissioner.

PN10873  

COMMISSIONER O'NEILL:  No.  Mr Ward, how about you?

PN10874  

MR WARD:  No.  I can hear her, but I can't see her.

PN10875  

COMMISSIONER O'NEILL:  Ms Moffat, would you mind just having another go and leaving and rejoining, and if that doesn't work we will take it from there.

PN10876  

MS MOFFAT:  Okay then, I'll just try again.

PN10877  

COMMISSIONER O'NEILL:  Thank you.  All right, Ms Moffat, it's almost like you popped out momentarily.

PN10878  

MS MOFFAT:  It could be the area too that we're in.  It might be a technical issue.

PN10879  

COMMISSIONER O'NEILL:  I think we might just press on in the circumstances.  Ms Moffat, I'm O'Neill C and my associate is just going to take you through the affirmation.

PN10880  

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

PN10881  

MS MOFFAT:  Maria Ann Moffat, and my work address is 155 Marius Street, Tamworth.

<MARIA MOFFAT, AFFIRMED������������������������������������������������������ [12.02 PM]

EXAMINATION-IN-CHIEF BY MR OSKI�������������������������������������� [12.03 PM]

PN10882  

COMMISSIONER O'NEILL:  Mr Oski.

PN10883  

MR OSKI:  Thank you, Commissioner.  Good afternoon, Ms Moffat.  I'm Sheldon Oski.  I'm appearing for the UWU today.  Can you repeat your full name for the record?‑‑‑Yes, Maria Ann Moffat.

PN10884  

I understand you've made a statement for the purposes of these proceedings, is that correct?‑‑‑That's true, yes.

PN10885  

And I understand that statement is dated 27 October 2021.  It runs to 52 paragraphs over five pages?‑‑‑Yes.

PN10886  

Do you have a copy of that statement with you?‑‑‑Yes, I do.

PN10887  

Have you had an opportunity to read through it again?‑‑‑Yes, I have.

PN10888  

Can you confirm it's true and correct to the best of your knowledge and recollection?‑‑‑The only thing at the moment is the employment history.  At the time I was working in the disability sector, but now I've ceased that work at the moment.

PN10889  

Thank you.  Commissioner, that's at document 244 at page 12164 of the digital court book ,and we seek to rely upon that statement.  Does the Commission require us to re‑file an amended statement in light of Ms Moffat's latest comment?

***������� MARIA MOFFAT�������������������������������������������������������������������������������������������������������������������������������� XN MR OSKI

PN10890  

COMMISSIONER O'NEILL:  No.  I think that's more in the way of clarification than a correction.  Ms Moffat, hopefully you can see Mr Ward in one of the boxes waving his hand?‑‑‑Yes.

PN10891  

He's now going to ask you some questions?‑‑‑Okay then, thank you.

CROSS-EXAMINATION BY MR WARD���������������������������������������� [12.05 PM]

PN10892  

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

PN10893  

Thank you, Ms Moffat.  My name is Nigel Ward, Ms Moffat.  I appear in these proceedings for the employer interest.  Do you have your statement in front of you?‑‑‑Yes, I do.

PN10894  

Can I just start with something you just said at the end there?  I take it when you made the statement you were doing both aged care, home care and disability home care, were you?‑‑‑I was doing aged home care, but I was doing disability privately.

PN10895  

I'm not trying to pry here, but when you say private, do you mean you had a second job, did you?‑‑‑Yes, I did.

PN10896  

And you've got both the Certificate III in Aged Care and the Certificate III in Disability, that's correct?‑‑‑In Aged Care, Disability, and Community Care.

PN10897  

Am I right that when you are working in aged care you draw on the skills from both of those certificates?‑‑‑I draw on from all of my certificates and my years of experience.

PN10898  

So you draw on your certificates and your years of experience?‑‑‑Yes.

PN10899  

I just want to understand paragraph 7 and 8.  I just wanted to ask a few questions about how you're set up as Australian Unity?‑‑‑Yes.

PN10900  

I take it that you report to the service coordinator, is that right?‑‑‑If we've got any issues we've got a phone call Procura where we can actually write dated notes.  We either date and note a lot of things, but if we have something that's arising that is a bit of an emergency or we feel it needs attention, we first go to the service co, yes.

***������� MARIA MOFFAT��������������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10901  

I take it that word, 'allocator', they're the people who build your rosters?‑‑‑That's right.

PN10902  

Does Australian Unity have registered nurses or enrolled nurses that it uses as well?‑‑‑We currently have one in our office; a registered nurse, yes.

PN10903  

Is it their job to come out and do clinical work if the people you're caring for need clinical work?‑‑‑Yes.  That's my understanding.

PN10904  

Is it the service coordinator who writes the care plan with the client?‑‑‑Honestly, I wouldn't be able to tell you yes or not of that.

PN10905  

So you don't know who writes the care plan?‑‑‑No, I don't.

PN10906  

But it's not you?‑‑‑No, it's not me.

PN10907  

Is the care plan provided to you on your app, or do you get a hard copy of it?‑‑‑No, the care plan's usually on our Procura app.

PN10908  

When you go to visit a client and you have to write progress notes at the end of visiting the client, do you write those in a book at the client's house or do you write them in the Procura app?‑‑‑Usually in both.  If there's a communication book at the client's, they're written there so the next girl knows what's going on, and they're also written in the dated note in the Procura.

PN10909  

Now, some people have said that if there's nothing out of the ordinary, they don't write anything.  They only write things if there's something out of the ordinary, an exception.  Do you write something in the book and the app regardless of what's going on?‑‑‑I do, for the simple reason there's not always the same girls going in.  So for instance, if I'm doing an hour personal care, that may only take half an hour, so then we might make the bed, clean the bathroom, clean the kitchen.  So that's all in my dated notes in the book so the next girl then knows what she can do to carry on that next service.

PN10910  

So you might have got a little bit ahead and you've been able to do something extra, and you don't want the person coming in after you to re‑do what you've already done?‑‑‑Yes, that's right.  Yes.

***������� MARIA MOFFAT��������������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10911  

Do I take it that you're currently providing both domestic support and personal care support?‑‑‑Yes, I am.

PN10912  

Is there a percentage breakdown between the two?‑‑‑Recently my domestic has probably dropped down a little bit, and the personal care has picked up.  That's probably with fluctuating employees.  But yes, I used to do quite a bit of domestic, but it's more and more personal care now.

PN10913  

Can I just take you to paragraph 15?‑‑‑Mm-hm.

PN10914  

Sorry, paragraph 14; I'll start there.  You say, 'Face‑to‑face manual handling training is conducted every two years.'  Does that run as a group program?‑‑‑Yes.  We usually have that, and there's so many out of each of our teams.  We've got three teams in Tamworth.  So it's so many out of each team come in and do their manual training or whatever other training is needed face‑to‑face, but the rest of them are done online.

PN10915  

Is the manual handling about how to move the client and those sorts of things?‑‑‑Yes, and how to do our domestic right:  how to mop, how to make beds.

PN10916  

Right?‑‑‑Yes.  There is techniques.

PN10917  

I believe you.  15, you say, 'Most other training is done through the LMS system.'  That's an online platform, I take it?‑‑‑Yes, it is.  Yes.

PN10918  

And when you say, 'other training', what other training are you provided?‑‑‑Well, we look up dementia.  We have dementia training, we have palliative care training.  There is then again our code of conduct.  Any sort of training we lead is on the learning app.  There's also extra courses there if we want to go in and do extra courses.

PN10919  

Let's just take a couple of those as an example.  Dementia training, how long does that take to do?‑‑‑It can � depending on how you read.  Sometimes you've got to read the questions or the information twice.  But it can take anywhere between half an hour and an hour to do.

PN10920  

Is there a test at the end of it, or is it just a thing you do?‑‑‑No, there is always a quiz at the end of them.

***������� MARIA MOFFAT��������������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10921  

And the palliative care, I take it that's similar?‑‑‑Yes.  I've only just got recently mine on there, so I haven't started my palliative care.  I've probably done a few palliative care out in the field, but that's come with other knowledge with, you know, with looking after parents as well.

PN10922  

Are those types of courses mandatory?  You have to do them?  The employer requires them or - - -?‑‑‑If we're going to do palliative care out in the field - - -

PN10923  

Yes?‑‑‑ - - - yes, it will be a mandatory course, I would imagine.  I actually asked for palliative care because that's where our aged is heading and a lot of them want to stay home, not go to nursing homes.

PN10924  

I take it that when somebody is in a palliative state at home they're being looked after by you and nurses and doctors at the same time?‑‑‑Yes and usually family members.

PN10925  

Are the nurses likely to be from your Australian Unity group or are they likely to be community nurses and things like that?‑‑‑Well, that would depend on what package or the circumstances the client has, yes.

PN10926  

So they possibly could be from you but they might be from community nurses or something else?‑‑‑Yes, that's sort of out of my field so, yes.

PN10927  

No, that's okay.  That's okay.  Just at paragraph 33 you talk about attending funerals and I'm a little surprised by that.  I thought it was fairly irregular to attend a client's funeral.  Is that � your employer doesn't have a rule about that?‑‑‑It's recently been brought into the EBA that, yes, that's a coverage and to us being out in the community it's not only a sign of respect.

PN10928  

Yes?‑‑‑It's closure for us.  That's my personal feelings.  I feel that that's something that it's nice for me to do which shows that I'm not on the job just for the money.

PN10929  

I just want to understand what you've just told me, so you're saying the employer allows it, it's your choice, and when you said it's just been covered off in the EBA, does that mean you're now given time off to attend the funeral?‑‑‑Don't quote me because I'm not actually sure of the writing in the EBA but I'm sure it's supposed to be if it's a long-term client you are supposed to get paid.

PN10930  

Okay?‑‑‑Yes but I'm not totally 100 per cent sure, yes.

***������� MARIA MOFFAT��������������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10931  

I understand.  I understand.  Then in paragraph 39 and 40 you talk about medications.  Did you do extra training to do your medications?‑‑‑Yes, I did.

PN10932  

Was that with Australian Unity or was that external?‑‑‑No, that was with Australian Unity.

PN10933  

Was that done by a registered nurse?‑‑‑Yes, that was in the office back in the day, yes.  Now there's probably a medication course that can be done but I think it still has to be signed off by the registered nurse.

PN10934  

Am I right that you prompt medication, you don't administer tablets?‑‑‑That's right.  We � a lot of us put them in the medication cup.

PN10935  

Yes?‑‑‑We count the tablets, we hand them to the client and the client takes them with a glass of water.

PN10936  

I take it that you're also trained to do eye drops and ear drops and things like that?‑‑‑Yes, we are.

PN10937  

You talk about catheters.  Do you have clients who have catheters?‑‑‑Not anymore.  Years ago we had quite a few but there doesn't seem to be many on my roster at the moment.

PN10938  

Could I just ask some questions about actually being on the job?  I'll just give you some examples, I just want to sort of see how Australian Unity do things.  If you were showering a client and you observed a tear on the client's skin, is that something that has to be reported to the service coordinator?‑‑‑Yes, that's exactly what we would do.  We would get that client out, we'd dress and whatever we needed to do.  Then we would contact the service co straight away because then she would put in place to get the registered nurse to come out and check.

PN10939  

In the meantime have you got first aid training to help?‑‑‑I do have first aid training but at the moment it is not up to � I haven't got a certificate now.

PN10940  

You have to call the service coordinator and the service coordinator talks to the registered nurse to go and deal with it?‑‑‑That's right, yes.

PN10941  

Am I right that something like that might also be recorded in Procura as well?‑‑‑It definitely would be and it would be in the communication book if there was one in the household.

***������� MARIA MOFFAT��������������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10942  

So the next person coming in could see that that had been observed by you on your shift?‑‑‑Yes, yes, yes.

PN10943  

If it's much worse than that, let's say that I'm seriously short of breath and you're concerned for me, is the procedure that you ring Triple 0 or is the procedure you ring the service coordinator?‑‑‑I ring Triple 0.  We get the ambulance organised and then we ring the service co, but we make sure the patient is right first before we go to that step.  The office is always notified if there's an ambulance called.

PN10944  

Is it the service co's job to ring the family?‑‑‑That I wouldn't be able to tell you because I'm not a service co.

PN10945  

That's okay.  No, that's all right.  That's fine, that's fine?‑‑‑Yes.

PN10946  

Does the service coordinator do the risk assessment on the house before you walk in?‑‑‑Sometimes they do.  I wouldn't say that that is 100 per cent because sometimes on Procura it can say that this has been an over the phone discussion.

PN10947  

Let me put it another way.  I take it that they're meant to do it but sometimes they don't?‑‑‑Well, I wouldn't answer that one because I really don't know.

PN10948  

That's all right, don't answer if you don't know the answer, that's fine, that's fine?‑‑‑Yes.

PN10949  

When you go to a resident, if you see a hazard are you required to report it?‑‑‑Yes, yes, we do it on a DoneSafe app on our phone.

PN10950  

That then goes back to the service coordinator, does it, to deal with?‑‑‑Yes, it does and we also get an email to say that that has been sent off and just to double-check our information is totally right, yes.

PN10951  

Is the service coordinator also responsible for you and the client care or is somebody else responsible for the client?‑‑‑I'm sorry but I wouldn't be able to answer that one.

PN10952  

No, that's okay.  That's fine, that's fine?‑‑‑Yes.

PN10953  

I'll take you to paragraph 35?‑‑‑Yes.

***������� MARIA MOFFAT��������������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10954  

You say there are occasional difficult clients?‑‑‑Yes.

PN10955  

I take it that if you're unsafe you have a procedure you have to follow?‑‑‑Yes, the first procedure we ever do when we go into a house is find an exit door.

PN10956  

Right?‑‑‑Then if we're feeling at all unsafe we just apologise to the client and say, 'Look, I'm sorry but I've just � you know, something's come up and I have to leave.'  Then we go outside, get in our car, move our car away from the residence and ring the office and tell them what's happening.

PN10957  

Have you had cause to do that?‑‑‑Not personally, no.  I, myself, have family members with mental issues so I have a little bit more of an understanding of how to settle them down a bit and I think as long as you're using a calm voice a lot of the people will settle down, yes.

PN10958  

You're very confident in your de-escalation techniques?‑‑‑Yes, yes and I think that just comes from experience at home.

PN10959  

You gained that experience working with family members at home?‑‑‑That's right, yes.

PN10960  

Just a moment, if I could?‑‑‑Yes.

PN10961  

Ms Moffat, thank you for your evidence.  Commissioner, no further questions.

PN10962  

COMMISSIONER O'NEILL:  Thank you.  Mr Oski, any re-examination?

PN10963  

MR OSKI:  No re-examination, Commissioner.

PN10964  

COMMISSIONER O'NEILL:  Ms Moffat, thank you very much for your evidence today.  You're excused and you're free to go?‑‑‑Okay.  Thank you for the opportunity.  Bye, everybody.

<THE WITNESS WITHDREW���������������������������������������������������������� [12.21 PM]

PN10965  

COMMISSIONER O'NEILL:  As I understand it, so that's it before lunch and then, as I understand it, when we resume we're starting with Ms McInerney and Ms Bucher.

***������� MARIA MOFFAT��������������������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN10966  

MR McKENNA:  Commissioner, if I can just indicate, Ms McInerney is available now, I understand, should the Commission wish to proceed with her evidence now.  Alternatively she can of course be available straight after lunch.

PN10967  

COMMISSIONER O'NEILL:  I'm content with that.  Mr Ward, any problems from your perspective?

PN10968  

MR WARD:  Let's press on, Commissioner.

PN10969  

COMMISSIONER O'NEILL:  All right, terrific.  Then please get her on the line.

PN10970  

Ms McInerney, can you hear me?  Ms McInerney, are you able to hear me?

PN10971  

MS McINERNEY:  Yes, I'm present.  Sorry, I'm present.

PN10972  

COMMISSIONER O'NEILL:  Lovely.  No, no, that's all right.  Thank you for your flexibility.  I'm Commissioner O'Neill, and my associate is just going to take you through the affirmation.

PN10973  

MS McINERNEY:  Good.

PN10974  

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

PN10975  

MS McINERNEY:  It's Irene Mary McInerney, Barrington Lodge, 120 Swanston Street, New Town, Hobart.

<IRENE MARY MCINERNEY, AFFIRMED����������������������������������� [12.25 PM]

EXAMINATION-IN-CHIEF BY MR MCKENNA��������������������������� [12.25 PM]

PN10976  

COMMISSIONER O'NEILL:  Mr McKenna.

PN10977  

MR McKENNA:  Thank you, Commissioner.

PN10978  

Ms McInerney, can you see me?‑‑‑Yes, I can.

***������� IRENE MARY MCINERNEY����������������������������������������������������������������������������������������������������� XN MR MCKENNA

PN10979  

Terrific.  I'm Jim McKenna, I'm one of the barristers for the ANMF in this matter.  Could I ask you to please again state your full name?‑‑‑Yes, Irene Mary McInerney.

PN10980  

And you are employed as a registered nurse at Barrington Lodge Aged Care Centre in Hobart; is that correct?‑‑‑That's correct.

PN10981  

Could you please provide the address for that facility again?‑‑‑120 Swanston Street, New Town, Hobart.

PN10982  

Thank you very much.  And, Ms McInerney, you have prepared a witness statement for the purpose of these proceedings?‑‑‑I have.

PN10983  

Do you have a copy of that with you today?‑‑‑Yes.  Yes.

PN10984  

Could I ask you to turn to page 12 of that document?  I'm sorry, I don't think it actually has page number, but perhaps the last page of the statement?‑‑‑I ended up numbering them.

PN10985  

Good?‑‑‑Yes, that's ‑ ‑ ‑

PN10986  

Thank you?‑‑‑ I'm on the last page.

PN10987  

And could I ask you to there confirm that it is a statement dated 29 October 2021?‑‑‑Yes, it is.

PN10988  

And it runs to 58 paragraphs?‑‑‑It's 58 paragraphs.

PN10989  

And you've had a chance to read that statement recently?‑‑‑I have.

PN10990  

Are there any changes, corrections, or clarifications that you'd like to make to that statement?‑‑‑Well, only one minor one, page 2, paragraph 7.

PN10991  

Terrific, bear with me.  So at the top of page 2?‑‑‑Yes, retirement age it's actually higher.  It's probably neither here nor there, but it should say 67.

***������� IRENE MARY MCINERNEY����������������������������������������������������������������������������������������������������� XN MR MCKENNA

PN10992  

So, 'I will definitely need to work beyond a retirement age of 67', is that the change?‑‑‑Sixty-seven, yes.

PN10993  

So, you change it from the 65 to 67?‑‑‑Yes.

PN10994  

Thank you?‑‑‑That's all right.

PN10995  

Subject to that change, are the contents of your witness statement true and correct?‑‑‑Yes.

PN10996  

Thank you.  And, Commissioner, that statement can be found at document 219, page 11758 of the court book.

PN10997  

Ms McInerney, on the screen in front of you, if you've got a number of squares can you see Mr Nigel Ward in one of those?‑‑‑Yes.

PN10998  

He's just raised his hand?‑‑‑Yes.

PN10999  

Mr Ward will have some questions for you now.  Thank you?‑‑‑Okay.

CROSS-EXAMINATION BY MR WARD���������������������������������������� [12.28 PM]

PN11000  

MR WARD:  Ms McInerney, can you hear me okay?‑‑‑I can hear you good.

PN11001  

Lovely.  Ms McInerney, my name is Nigel Ward.  I appear in the proceedings for the employer interests, and I'm going to ask you some questions.  Do you have your statement in front of you?‑‑‑I do.

PN11002  

Okay.  I'm not going to keep you too long, so, bear with me.  Could I just start off by taking you to paragraph 15?  You describe in paragraph 15 your position as a registered nurse in charge.  I wonder if you could just clarify for me what the difference between registered nurse in charge is as opposed to just being a registered nurse?‑‑‑I just want to look at the context of this.

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11003  

No, that's fine.  That's fine, you go to it and you read it before you answer the question?‑‑‑In charge to me is the same as supervisor.  Some morning shifts, for instance, there might be two registered nurses on.  But in the afternoon it's the same, and if you're in charge the other two people on could be enrolled nurses.  It could be a registered nurse and an enrolled nurse, and then the in charge RN.  It's always in charge RN.

PN11004  

So, it signifies that you're the most senior RN on?‑‑‑Exactly, yes, most senior.

PN11005  

No, no, thank you for that.  Thank you for that.  And in paragraph 16 you talk about your hourly base rate of pay.  Is that currently your hourly rate of pay, or has it changed since you made the statement?‑‑‑No, it's current.  I checked yesterday.

PN11006  

Thank you for that?‑‑‑I wish it was more, yes, but - okay.

PN11007  

Now, can I jump you all the way to paragraph 31?‑‑‑Thirty-one.  Right, I'm there.

PN11008  

Thank you very much.  You talk in paragraph 31 about observations of changes in both resident and staff profiles, and you say:

PN11009  

The compositions have meant that the work of each RN, EN and carers has been transformed over the last 15 to 20 years.

PN11010  

Do you see that in your statement?‑‑‑I think it's more what that's getting at is that it's more to do, like, with the hands-on, just role changes, like, there's things that carers are doing now that enrolled nurses used to do, and there's things now that enrolled nurses may be more responsible for, so that the RNs are freed up for other things.  It's more of a just shift in, I don't know, responsibilities, for want of a better word.

PN11011  

That's fine.  I'm just going to explore those slowly with you if I can.  So, you often have enrolled nurses working under your supervision, don't you?‑‑‑Yes.

PN11012  

Could you describe for me typically what an enrolled nurse would do in their day working under your supervision, what activities?‑‑‑Yes, well, is this when I'm in charge?

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11013  

Yes.  Let's say you're on shift and you have an enrolled nurse working with you, what are the activities the enrolled nurse will do?‑‑‑Okay, well, Barrington Lodge is largely split in half, if you like, so the enrolled nurse would do all of the medications, and any clinical aspects like wounds and tasks that are assigned for her half of the building, and there could be an enrolled nurse on the other half and overall I would have to oversee that and also do Schedule 8 medications.  It takes a registered nurse to fulfil some medication obligations.

PN11014  

I'll go through these in a minute with you slowly, to be fair to you, but you said medications, wound and clinical tasks.  What other clinical tasks might an enrolled nurse do?‑‑‑Right.  There will be � there's leftover tasks because we use the iCare online system and there will be tasks.  There may be some leftover.  It could be assessing a pressure area.  They are � they have their own Dect phone so the carers on their wing will contact them first and if that enrolled nurse needs to ask me something it escalates up the chain and the enrolled nurse has to - - -

PN11015  

That would be a supervisory role by the - - -?‑‑‑ - - - go through me as needed medications, prepare for any medications.

PN11016  

They play a supervisory role to the personal care worker?‑‑‑Say again, sorry?

PN11017  

Do they supervise personal care workers, the ENs?‑‑‑Well, they're the first in line to do that and then overall I've got the overall responsibility to ensure that they're coping to be able to do that as well, and look at the workload and aspects like that.

PN11018  

They could be a first point of contact for the care worker.  They will then make their decision as to whether or not they can deal with the issue or escalate it to you?‑‑‑Yes.

PN11019  

Yes, okay, and in terms of medications, I don't know if it's your understanding, it's my understanding that the qualification for an enrolled nurse qualifies them to do medications.  Is that your understanding?‑‑‑They're endorsed with medications but there's still Schedule 8 medications that they cannot do alone.  Examples of that would be narcotics, injectables.  Insulin is even checked by another person.

PN11020  

Yes?‑‑‑Those types of administrations need to have the registered nurse as the second signatory by law.

PN11021  

My understanding is that the administering of Schedule 8s, that's a matter for you as the registered nurse, is that correct?‑‑‑Yes, yes.

PN11022  

Yes and I'm right, aren't I, that if you're endorsed as an EN, you can administer Schedule 4 medications?‑‑‑Indeed, yes.

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11023  

Yes and in your facility do the ENs do the Schedule 4 medications or do the personal care workers?‑‑‑No, the enrolled nurses and if it's not a regular Schedule 4 medication they have to ask the registered nurse the situation to give permission to give.

PN11024  

That's been described in this case as a PRN, is that right?‑‑‑Exactly, yes, a PRN.

PN11025  

In terms of the Schedule 4 medications, we'll just start with tablets if we can.  I take it that your facility operates with blister packs or Webster packs for the resident?‑‑‑Yes, we have what they call the MPS, it's like a sachet roll of tablets.

PN11026  

Right?‑‑‑The rolls and we break them off and � yes.

PN11027  

The enrolled nurse, in administering the tablets, I would be correct, wouldn't I, the enrolled nurse has to verify that the tablet is the correct tablet?‑‑‑Yes.

PN11028  

Different people have described how that's done but my understanding is that they would check both the name and possibly even a picture chart of the tablet against what's kept on your system.  Is that similar to what you do?‑‑‑Yes, it is.

PN11029  

Yes and is that information kept on an iPad or where is that information kept for the enrolled nurse?‑‑‑We have an iPad and in a separate app, if you like, there is tablet identification.

PN11030  

I take it that once the enrolled nurse has verified the tablet is correct, they administer it.  If the resident requires it crushed and put in a custard or something like that, that'd be for the EN to do, wouldn't it?‑‑‑Yes, for their half of the building.

PN11031  

Right?‑‑‑There's instructions with a photo of the person on the safest method of administration.

PN11032  

If they observe something, like it's not the right tablet, I take it they immediately contact you as the RN?‑‑‑Exactly, they do.

PN11033  

It's your decision then as to what happens next?‑‑‑Definitely, yes.

PN11034  

Yes and the endorsed medication status, that allows them to do medicated eye drops and medicated ear drops as well?‑‑‑It does.

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11035  

Administering insulin, is that something you do or is that something the EN will do?‑‑‑They can do it, we both check basically at the bedside but they can do the administration.

PN11036  

You might be observing but they can actually put the pen into the resident?‑‑‑They can.  Yes, they must check the units, the amount of units dialled up, if you like, you know, that it matches the order.

PN11037  

Yes?‑‑‑So there has to be the two of us there for that.

PN11038  

When you're doing your Schedule 8 round, my understanding is you need a second person to confirm what you're giving them.  Is that an EN as well?‑‑‑Yes, that has to be a registered nurse and an EN or a carer.  See, on night shifts it's the carer doing that second check in the registration book and at the bedside.  There's always two or three people have to present at - - -

PN11039  

For Schedule 8?‑‑‑For Schedule 8s, yes.

PN11040  

My understanding, that second person is effectively confirming that you've got it right?‑‑‑Well, it's by law but - - -

PN11041  

Yes?‑‑‑- - - ultimately, yes, they have to have that 100 per cent right.

PN11042  

We've heard some things in this case about opioid patches.  Do you administer opioid patches as well?‑‑‑Yes, I'd say every afternoon shift I do, we do because there's two different types of patches.  That's another S8.  It might be a patch that goes on every three days or weekly.

PN11043  

Yes?‑‑‑It's the same thing, that two people have to take the patch to the bedside, verify the identity of the person and proceed.

PN11044  

That's a Schedule 8 thing so the Schedule 8 process applies?‑‑‑Yes.

PN11045  

I'll come onto wounds in a minute but � no, I'll do wounds now.  When you say ENs now do wound care, let's say that I was being showered this morning and somebody observed a tear.  Am I right that when you say they would do wound care, would the RN still inspect the wound and decide what has to happen to it?‑‑‑I believe that's the best clinical way more to support that person but it can come down to staffing and who's available at the time.

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11046  

You might let an EN play that initial role?‑‑‑Yes.

PN11047  

Yes?‑‑‑And I expect a phone call if there's more complexities, if it's something that's not simple.  We do take a photo of a wound when it's new.

PN11048  

Yes?‑‑‑And ideally I should see that and know what has gone � been applied as a dressing.

PN11049  

So the EN obviously is working within their scope of practice?‑‑‑They are.

PN11050  

And obviously you're confident in delegating that activity to them in particular situations?‑‑‑Yes, that's correct.

PN11051  

If it's complex you either intervene or expect the EN to come and get you?‑‑‑Yes, that's right, I expect it to be escalated for my involvement.

PN11052  

Are there any rules around � I take it you've got residents who have catheters?‑‑‑Yes.

PN11053  

Whose job is it to actually put the catheter in?‑‑‑Often the catheters are every six to eight weeks.  It'll come up on a given day on the task list.  Depending on if it's an enrolled nurse or a registered nurse that's on, I think sometimes it comes down to a confidence level.  You know, I'm prepared to take over something if a person feels they haven't done a procedure and it could be years, you know, something, you know, that hasn't cropped up on their shift in a long time, and so I'll give them support with it, or maybe do a procedure myself.

PN11054  

Okay.  So you might put the catheter in or if an enrolled nurse was sufficiently confident they might do it?‑‑‑Yes.  Yes, we do have a discussion - two of us did one the other day for instance just so we could talk it through and everyone was on the same page.  It gives the resident more, I don't know, confidence then too.  Yes.

PN11055  

Now, can I turn for a moment to the personal care worker.  Do all your personal care workers have Certificate IIIs or do they have higher qualifications, what do they have?‑‑‑It'll be IIIs or IVs.

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11056  

Is that a requirement or is that just if they want to get them they can get them?‑‑‑It's a requirement.  I would feel upset for anything less to be honest, we need skilled people.

PN11057  

Yes, okay.  As I take it what you just said to me that Certificate III is the base.  What's the decision to have somebody do a Certificate IV?‑‑‑I'm not - it's one that I'm not too sure on I'm afraid.  It'd be a personal choice I'd imagine to extend their education.

PN11058  

Okay, that's fine.  Now, I just want to understand what the personal care worker might do in comparison to the enrolled nurse if we can, and I just want to take you through some examples and just see sort of where we end up.  If a resident has a fall is it a requirement of the personal - let's say the personal care worker gets their first - is the protocol that you have to be called or could an EN be called?‑‑‑Rarely - the most senior person on if the registered nurse is on, on charge, we get the call first.

PN11059  

Are you the person who makes the decision as to, for another way of putting it, sort of the diagnosis of what you do with that resident after the fall?‑‑‑Yes.  Because if it is an enrolled nurse's half of the building and I'm in charge and go there as well I'll support the whole process and maybe delegate what happens next, you know, please do the blood pressure and assist them to bed, whatever, but the assessment has concluded as the best thing to do.  If it's a complex case I help myself as well, you know.

PN11060  

So you could possibly do the assessment yourself or you could be doing it with an enrolled nurse under your supervision?‑‑‑That's right.

PN11061  

After you've made the assessment I take it you decide if the resident can be moved or something like that?‑‑‑I'd prefer it to be my decision, yes.  If I'm there and in charge definitely my decision.

PN11062  

And if they're to be moved is that when the personal care worker steps back in and helps out?‑‑‑That's right.  That's right, because with the manual handling policies and requirements you have to have two or three people, depending on what hoist you use, but, yes, they can be involved at that point and you can talk them through your expectations.

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11063  

And if you form the view in your assessment that that resident had to be observed in a particular way for the rest of the day would you be communicating that to the personal care worker so they do that?‑‑‑I'd prefer to be more to the enrolled nurse that's on duty, because a lot of (indistinct) falls you have to do regular observations anyway such as blood pressures and that, and it gives either of us a chance to keep a good vigil of assessment at regular intervals, 15 minutes, half hour intervals.  But with the carers I would expect if they've gone past the room and see something out of the ordinary to immediately let us know.

PN11064  

So in terms of the ongoing observation of that person, the taking of blood pressure, you would delegate that to an enrolled nurse?‑‑‑Yes, and it could be myself if they're tied up with a pill round.  It is a registered staff member's responsibility.

PN11065  

Let's assume - I just want to do a few more if I can - let's assume that I'm the resident and I'm in the shower, and the personal care worker observes a bed sore or a bruise or a tear in my skin, is that communicated first to the EN or is it elevated up to you?‑‑‑It could be to the enrolled nurse first, and then she might go and have a look at the - if it's anything of complexity and then in turn ring myself for - you know, just for another opinion perhaps or to know this course of action.

PN11066  

Your EN could say, 'Look, I've seen one of these before, it's not that bad.  I'm comfortable with it, I'm just going to send you a photo in case'?‑‑‑Yes, that would be - that would be permissible.

PN11067  

Or it might be that the enrolled nurse says, 'Look, this looks quite serious, I really need you to get down here and have a look'?‑‑‑Right.  Yes, I would expect them to do that for the best assessment outcome.

PN11068  

While that assessment is being undertaken by the EN or yourself what's the role of the personal care worker?‑‑‑Well, I expect them to be on stand-by so that we can instruct, 'Look, that arm's not to be moved, but proceed to keep drying and showering them', and all this type of thing, or put your waterproof bag on.  You know, just whatever instructions will follow, but they can proceed with perhaps just (indistinct) finishing the showering process.

PN11069  

I see?‑‑‑I don't want them to go away, I want them to stay on stand-by so I can just say, 'Look, let's just dress this', and continue.

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11070  

And so you would want them - as much as possible you would either want them to carry on finishing off their job or to be on stand-by in case you need some help moving the person or something like that?‑‑‑Well, that's right, because our time can be quite tight in a day and nobody wants to hold up the next person.  So if I have to dress something for instance I say, 'Right, continue to dry their back' - if it's a shower - just, you know, do what you can around - you know, away from the site of involvement, say it's the hand or something, and we'll get back and do that dressing and that.  Yes, it's a matter of being on the same page, team work, you know.

PN11071  

Yes, I understand.  Let's say in that circumstance my tear had to be dressed and bandaged, and let's say you said, 'Look, I need that redone tomorrow morning', is that a job for the care worker or is that a job for the enrolled nurse?‑‑‑No, that's a job for the enrolled nurse.

PN11072  

A couple of other examples if I can.  Let's assume that I was the personal care worker and I'm observing the resident.  I might be in their room.  I've just finished showering them and I sense that their behaviour is not what it normally is.  Let's say that they seem to be not as talkative or responsive as normal.  Is that something that would in your facility, is that something that gets escalated straight away or is that just something that's recorded on some progress notes?‑‑‑No, the expectation is that - we all carry Dictaphones - immediately let someone know for an immediate assessment.  That person could have a delirium and these types of things can happen quite quickly.  It could be the person has urinary tract infections all the time and they knock some people around harder than others, so we've got to be very timely.  You know, it's about good communication.  If they see something out of the ordinary - because the carers have a lot of hands-on and we don't see people to the same extent, so we really do rely on their good sense, 'This doesn't feel right', I'd want them to escalate it straight away.

PN11073  

Would that come straight to you in your facility or would it go via the EN?‑‑‑I think it depends on the extent of it, because if it was - you know, the carers you hope on their skill level if you like or confidence, 'Irene should know about this', and they can call me directly and then I can let the enrolled nurse or whoever's on charge, 'Look, this is going on and I'm heading to the room' - you know, keep her in the loop as well.

PN11074  

I take it that you would then undertake an assessment similar to the one we talked about with the wound care?‑‑‑Well, that's - because the carers eyes and ears are really useful, so I could say, 'Look, how long have they been this way' - you know, just get a brief history, and maybe I'd look back - if it's something that I will keep looking back on the notes what's happened with that person recently and make decisions, but in the meantime obviously keep the observations going, the enrolled nurse calling in more often to that room and letting me know of changes while I'm researching the history in some cases.  Yes, we do that.

PN11075  

There's a couple of activities that have been discussed in this case.  I want to take you through two of them to see how you operate.  Who normally takes blood pressure in your facility?‑‑‑Just the registered staff, so it could be the enrolled nurse or the registered nurse, no one else.

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11076  

We've heard that sometimes when you say, 'blood pressure', there's like a traffic light system and a green/yellow/red.  Do you use that, or because it's a registered staff member you don't use things like that?‑‑‑That doesn't sound familiar to me.

PN11077  

I think the answer is no.  That's fine?‑‑‑No.

PN11078  

Do you have diabetic residents?‑‑‑Yes.

PN11079  

Who takes blood sugar readings for those?‑‑‑Just the enrolled nurses and registered nurses.  I wouldn't feel comfortable with anything less.  It's important to know what to do with readings that are out of the normal parameters.  You've got to sort of have time to react quite quickly in cases, see.

PN11080  

Yes, I do.  If I just keep you just a little while longer, if I could.  Am I right that you will personally be involved in the admission of a resident?‑‑‑I can have involvement in that.  It actually can be quite advantageous.  You get to know the person fairly well, but we have a registered nurse that will be on to see admission through from woe to go, to get that history down.  But I don't mind personally being involved in the process otherwise.  We've got to read up after the fact anyway.

PN11081  

Is that person described as an admissions nurse, is it?‑‑‑Yes, that'll be � it's often a registered nurse, but an enrolled nurse might be called in if we got a couple in one given day, because it's a big workload.  But it's always a registered or an enrolled nurse that sees to those.

PN11082  

Is that person the person who writes the initial care plan, or is that you later on?‑‑‑It's a bit of both, because the care plan can be started, because we need to get dietary and mobility and some of the safety aspects done by the nurse, and then we just add on later behaviours � continence - you know, the timeframes for when the rest of it has to be done.

PN11083  

I take it your facility has a copy of the care plan available to all RNs, ENs and care staff?‑‑‑Yes, everyone can access.

PN11084  

Do you have like summary sheets about mobility and things like that in the actual room?‑‑‑In the actual room?

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11085  

In the resident's room, do you have little summaries of things like the resident's likes and dislikes, or their mobility or things like that?‑‑‑The mobility is, because the physios ensure that's behind the bathroom door to reflect the current practice.  Things change, and you need to know that at a glance.  But likes and dislikes are more at the care plan handover part, not provided in the room as such.

PN11086  

The mobility part, for instance, that might explain whether or not you need two people to lift me or something like that?‑‑‑Yes.

PN11087  

Am I right that obviously you'll regularly be reviewing the progress notes on all the residents?‑‑‑The progress notes?  Well, when I start my shift and especially time permitting, after handover I'll go through the progress notes of where people have been sick or there's changes, just so you feel more comfortable, got a little bit more information, and then you know who to go to first to assist them or see how the shift started with them, if there's something else we need to do or someone else to call.  But, you know, it's impossible to go through each and every progress note.

PN11088  

You do it by way of exception if there's been an incident on - - -?‑‑‑Exceptional, exactly, yes.

PN11089  

And you work out then what your priorities are when you start?‑‑‑Yes.  It's like real triage, I tell you.  It can be full on.  But that's right, we've got to be really good at prioritising those needs, what needs to be done early.  Sometimes if it's outside phone calls, you've got to do them the earlier the better, because organisations close or different things like that.

PN11090  

I appreciate that you obviously work with a lot of people who have various forms of dementia at various stages?‑‑‑Very much so.

PN11091  

And I take it that dealing with challenging behaviours is part of your daily life?‑‑‑It is.

PN11092  

Do you have any procedures to make sure you don't find yourself in an unsafe situation?‑‑‑Myself in an unsafe situation, or just any staff member?

***������� IRENE MARY MCINERNEY��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11093  

I'm asking about you, but I'm happy to hear about any staff under your supervision.  Are there procedures � if you feel unsafe in a situation, what's the procedure you're meant to follow?‑‑‑Well, that's where our schools come into action, because it's about knowing the resident, if you know giving them a wide berth helps.  We rely on phone calling each other.  If something was truly that unsafe we'd get the police involved, because there's SIRS reporting, you know, the serious incident reporting.  You want to kind of diffuse something before it happens, before somebody might � their mood might be that they'll take it out on someone else, because it's in our best interest to perhaps nip things in the bud, if you like.  It's about knowing the resident and what keeps them happy, and diverting.

PN11094  

I take it that you're quite confident about your ability to de‑escalate situations?‑‑‑Yes, I am.

PN11095  

Is that in part because of your nursing training as well?‑‑‑I think it's a range of things, because I've done aged care for quite some time.  I've had mental health illness with family members that I've assisted.  Life experience - I think you can't underestimate just, you know, maturity of years, if you like, because I'm 60 next year.  But I'd like to think I'd have an answer to any of these one‑off things that might crop up, to keep everyone safe at the end of the day, you know, because a lot of the carers haven't got the same years behind them to start with, much less experience, so I've got to be there to give them confidence � hey, we can deal with this and we will be all right, you know.

PN11096  

Ms McInerney, thank you very much for your evidence.  No further questions, Commissioner.

PN11097  

COMMISSIONER O'NEILL:  Is there any re-examination, Mr McKenna?

PN11098  

MR McKENNA:  Thank you, Commissioner.  I will be brief.

RE-EXAMINATION BY MR MCKENNA������������������������������������������ [1.00 PM]

PN11099  

MR McKENNA:  Ms McInerney, you were asked in the context of questions about tasks an EN might undertake, and you were referring to the assessment of pressure areas, and you talked about the fact that carers may call an EN on a Dect phone.  Can you just explain what a Dect phone is?‑‑‑Each phone has a three‑digit number and it might have, say, AS‑271.  That would be afternoon shift 271, that'd be my phone.  It's always the same digits, say.  But each phone has three digits on it and we've got a list in our pocket who holds that phone so we can communicate with our team members, or the next � or the enrolled nurse, the RN in charge.

PN11100  

Thank you?‑‑‑Yes, but people just discern which person they feel needs to know about this next.

***������� IRENE MARY MCINERNEY�������������������������������������������������������������������������������������������������� RXN MR MCKENNA

PN11101  

Thank you.  And on a similar topic I guess, you were asked a question about the distinction between an enrolled nurse and a registered nurse, and you were asked if there was a fall who would a carer call - would they call a registered nurse or enrolled nurse, and I think in answer to that your response was that they would call the most senior person who is on, and you went on to say that if an RN is on we would get the call first.  Do you recall that?‑‑‑No, I recall the conversation, yes.

PN11102  

Is it the case that an RN will not always be on to take that call?‑‑‑No, there's - we have an RN on shift 24 hours at our facility, so, they will always - hopefully always available.  If we're attending to another call we get the next thing if there's - it could be the enrolled nurse if a couple of things are happening side-by-side.

PN11103  

Thank you.  And then, finally towards the end of the cross-examination you were asked some questions about your review of progress notes, and then you were asked some questions about admissions, and you made a comment to the effect that it was, like, triage.  And then you went on to say that you must be really good at prioritising needs, and you referred to making outside phone calls.  Do you recall that?‑‑‑I do, yes.

PN11104  

Can you just explain who those outside phone calls may be to?‑‑‑Right.  Well, it could be to the hospital, because - it could be to a hospital department because a person has just been transferred back, and they may not have come back with all their medications, and you have to get on with that.  You know, in case they need to deliver something.  It could be to family members that are older and you don't want to disturb them into the evening.  It could be all manner of things, but with the triage, I mean, sometimes you want to get things done during business hours, pathology aspects, come in pick up the specimen, it could be a variety of things, so registered nurses, we have to be really flexible as well as thinking - you know, just putting things in order, if you like, prioritising.  Yes.

PN11105  

Thank you, Ms McInerney.  And thank you for your flexibility today, changing the time to come in earlier.  That's much appreciated?‑‑‑Thank you.

PN11106  

Commissioner, I have no further re-examination.  Might the witness be excused?

PN11107  

COMMISSIONER O'NEILL:  Ms McInerney, again, thank you for your evidence this afternoon, and you're excused and free to go?‑‑‑Okay.  Thank you for this opportunity.  Thank you.

<THE WITNESS WITHDREW������������������������������������������������������������ [1.04 PM]

PN11108  

COMMISSIONER O'NEILL:  We'll adjourn and resume at 2 pm.  The Commission is adjourned.

***������� IRENE MARY MCINERNEY�������������������������������������������������������������������������������������������������� RXN MR MCKENNA

LUNCHEON ADJOURNMENT����������������������������������������������������������� [1.04 PM]

RESUMED����������������������������������������������������������������������������������������������� [1.59 PM]

PN11109  

COMMISSIONER O'NEILL:  The Commission is resumed.  Is it Ms Boucher or Ms Boucher next?

PN11110  

MR HARTLEY:  Commissioner, Mr Ward has informed my client that Ms Boucher is not required for cross-examination, so I thought what I might do, if it's convenient to the Commission and to other parties, is identify the few minor changes that were to be made to Ms Boucher's statement, and then indicate that we rely upon that statement.  Is that a convenient course?

PN11111  

COMMISSIONER O'NEILL:  It is.

PN11112  

MR HARTLEY:  Excellent.  In paragraph 5, Ms Boucher would have indicated that she's no longer employed full time in the role that she there indicates.  She ceased that role on 22 April 2022.  She would have said that she's now engaged as an NP by Access Aged Care to provide consulting services to residents in residential aged care facilities in Tasmania in cooperation with local virtual medical specialists, and that the residents generally have specialist care needs.

PN11113  

The second matter is at the very end of paragraph 7 she would have added that she is a health practitioner and member of the Tasmanian Nursing and Midwifery Board.

PN11114  

So unless that causes any difficulty for any of the parties, we'll attend to do those amendments and provide the updated statement to the Commission.

PN11115  

COMMISSIONER O'NEILL:  Thank you

PN11116  

MR HARTLEY:  I should state that that's at tab 218 at page 11736 of the digital court book.

PN11117  

COMMISSIONER O'NEILL:  So, Mr Oski, does that put the ball back in your court with the next witness being Ms Wahl?

PN11118  

MR OSKI:  Yes, Commissioner.  I'm just in the process of confirming if Ms Wahl is available to appear earlier.  It's my understanding that she's not, but I'm just confirming with my instructors now.

PN11119  

COMMISSIONER O'NEILL:  All right.

PN11120  

MR OSKI:  And while we're waiting for that I will just note that the UWU no longer intends to rely on the statement of Ms Kirsten Conroy because the witness is unavailable to present for cross-examination.  That's at document 241 at page 12148 of the digital court book.

PN11121  

COMMISSIONER O'NEILL:  We'll adjourn just while you're waiting to ascertain Ms Wahl's availability, and if you can just let my associate know when she's available, we'll resume at short notice.

PN11122  

MR OSKI:  Thank you, Commissioner.

SHORT ADJOURNMENT�������������������������������������������������������������������� [2.03 PM]

RESUMED����������������������������������������������������������������������������������������������� [2.10 PM]

PN11123  

COMMISSIONER O'NEILL:  Ms Wahl, can you hear me all right?

PN11124  

MS WAHL:  Yes.

PN11125  

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

PN11126  

MS WAHL:  Yes, thank you.

PN11127  

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

PN11128  

MS WAHL:  My name is Jane Natasha Wahl.  I work at Gloucester Residential which is 26 � what's the name of the street?  I've only worked there 17 years.  Roopena Street, that was it, Ingle Farm.

PN11129  

THE ASSOCIATE:  Thank you.

<JANE NATASHA WAHL, AFFIRMED�������������������������������������������� [2.10 PM]

EXAMINATION-IN-CHIEF BY MR OSKI���������������������������������������� [2.10 PM]

PN11130  

COMMISSIONER O'NEILL:  Mr Oski.

***������� JANE NATASHA WAHL�������������������������������������������������������������������������������������������������������������������� XN MR OSKI

PN11131  

MR OSKI:  Good afternoon, Ms Wahl.  My name is Sheldon Oski, I'm appearing for the UWU today.  Can you just repeat your full name for the record?‑‑‑My full name is Jane Natasha Wahl.

PN11132  

I understand you've made a statement for the purpose of these proceedings, is that right?‑‑‑Yes.

PN11133  

That statement is dated 21 April 2022 and runs to 45 paragraphs over six pages?‑‑‑Yes, yes.

PN11134  

Have you had an opportunity to read through it again?‑‑‑I was just starting to read it again but I read it last night.

PN11135  

When you read it last night is it true and correct to the best of your knowledge and recollection?‑‑‑Yes.

PN11136  

Commissioner, that's a reply statement filed by the UWU on 21 April 2022.  That does not yet appear in the digital court book but copies have been circulated and I believe most recently by Mr Ben Redford yesterday at 9.38 am.

PN11137  

COMMISSIONER O'NEILL:  Yes, I think they may actually be at the end of the submissions that were filed but, yes, I appreciate that.

PN11138  

MR OSKI:  Thank you.  We seek to have that added to the court book and we seek to rely upon that statement.

PN11139  

COMMISSIONER O'NEILL:  Yes.

PN11140  

MR OSKI:  Ms Wahl, you will be able to see in one of the windows of your screen Mr Nigel Ward.  He'll now ask you a few questions.

CROSS-EXAMINATION BY MR WARD������������������������������������������ [2.12 PM]

PN11141  

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

PN11142  

Mr Wahl, my name is Nigel Ward, I appear in these proceedings for the employer interests.  I'm going to ask you some questions.  Do you have your statement in front of you?  You do, don't you?‑‑‑Yes, I do.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11143  

That's good.  You say when you made the statement you'd been in the job for 16 years.  I assume that that's a year and a half ago which - - -?‑‑‑Yes, yes.

PN11144  

- - - brings up to 17 years.  What did you do for a living before you became the gardener?‑‑‑I was in childcare.

PN11145  

Right?‑‑‑Yes, for two years and studying, unemployed, yes.

PN11146  

When you started at Gloucester you didn't have any gardening experience before?‑‑‑No, I've had experience.  When you study horticulture they get you to have experience, you work at other sites.  So one of my sites was an aged care facility.

PN11147  

Tell me when you started at Gloucester, what year?‑‑‑2006.

PN11148  

When you started, that's when you did your certificate 2, was it?‑‑‑I did my certificate 2 before I started working at Gloucester.

PN11149  

Okay?‑‑‑So it took me about a year to get a job, so about 2005, yes, I started.

PN11150  

You started certificate 2 in 2005 and that gave you exposure to gardening before you joined Gloucester?‑‑‑Yes.

PN11151  

Then in 2018 you did a certificate 3 in laboratory studies?‑‑‑Yes.

PN11152  

I've tried to find it but I've struggled, you're going to have to help me.  What are laboratory studies?‑‑‑It's a cross between, like, you're growing bacteria on Petrie dishes and pathology.

PN11153  

It's got nothing to do with gardening?‑‑‑No.  I wanted to branch out into the labs with a horticultural stint but that's not available in South Australia, so that was the closest I could study at that time.

PN11154  

Just if I can understand, you did that qualification to move into a different work field and I take it that work field would have - - -?‑‑‑It's not a different work field.  I wanted to stay in horticulture.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11155  

Right?‑‑‑But I wanted to do something in a lab.

PN11156  

If you worked in a horticultural lab, just what is it you would have been doing?‑‑‑To my knowledge, there's varying things, like, if you're in viticulture you'd be testing bacteria for the plants you're about to grow.  You'd be producing new plants through tissue culture, testing seeds for bacterial growth to see if they're healthy, those kind of things.  But because I didn't actually study it, it may be more, it could be less, so - - -

PN11157  

I take it you could have studied a certificate 3 in horticulture at the time but did you decide not to do that?‑‑‑It was government funded and I got confused about it being a complete course.  I thought I'd completed it and when I went for the job at Gloucester, I told them I had a certificate 3 but found out I didn't at a later time, so - - -

PN11158  

Initially back in 2006 you thought you were doing your cert 3 in horticulture but it wasn't cert 3?‑‑‑Yes, I did it for six months and nobody told me to come back so - - -

PN11159  

Right?‑‑‑But I had a job at that point so, yes.

PN11160  

At that stage at Gloucester they didn't require you to get your certificate 3?‑‑‑No, I was very over-qualified.

PN11161  

For the job?‑‑‑Yes, yes, for the job.  They just wanted maintenance care/gardening, so they didn't require anyone to be a horticulturalist.

PN11162  

You say in your statement you work part-time.  How many hours a week do you normally work?‑‑‑20.

PN11163  

20 hours, right.  Am I right that you have an offsider helping you on occasions?‑‑‑Yes, he's a special needs person.  He has a hearing issue but he comes in twice a week to help me water.

PN11164  

Is that a paid job or is he just coming in to help?‑‑‑When he first started it was voluntary but there was a government scheme at the time which allowed him to be employed.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11165  

I don't know the Gloucester set-up very well so I'm just going to ask you some terribly basic questions if I can.  You describe it in paragraph 6 in this fashion, you say:

PN11166  

It's a modern-looking facility with a classical tilt.

PN11167  

?‑‑‑Yes.

PN11168  

Can you help me out what that means?‑‑‑The classical tilt is the paintings, the artwork are classical.  The furnishings that they buy.  They try to keep it more classical because of the age groups that they're dealing with there.  The modern look of it is mostly because the place is sterile and it's almost hospital-like so, yes.

PN11169  

Is it just one big building on the plot of land or is it multiple buildings?‑‑‑It's multiple wards, all connecting to a main section and a couple of corridors.  So you can get to each ward from a central position.

PN11170  

I take it when you arrived in 2006 it was already built?‑‑‑Not all of it.  We've had two extensions.

PN11171  

Since you've arrived?‑‑‑Yes.

PN11172  

By extensions you mean they've built two more wings, is that a good way of describing it?‑‑‑Yes, they built an entire ward and then during the second stage they added to that ward and they added to a couple of other wards and built another entire ward, from memory.

PN11173  

Do you know how big the plot of land is that the facility is on?‑‑‑God, I wouldn't know how big it is in acreage but there are eight wards, six on the ground.  And there are gardens, a minimum of four metres, around each of those wards.  In some sections it's better.

PN11174  

It's an acreage, is it?‑‑‑All I know is that we take up the entire block of the � because we have a road behind us and road in front, and we take up all of that section, so I can't be exact to how much acreage there is.

PN11175  

Is a large part of the acreage taken up with lawns?‑‑‑No, because I got rid of them.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11176  

You've got something against lawns, or - - -?‑‑‑No, no.  The drought that we had about ten years ago, water restrictions, I had to get rid of some of them, the lawns.

PN11177  

They were dying off, were they?‑‑‑Yes, because I couldn't keep up with the watering during the times that we were allotted.

PN11178  

And what's the major ground cover if it's not turf?‑‑‑Mostly gardens.  Wherever there is lawn there are ornamental gardens surrounding them and pathways.  The majority of the garden would be path, just so there's clear access to every garden for people in a wheelchair.

PN11179  

So there's more pathway than garden beds, is there?‑‑‑Now that I think about it probably not.  It just seems like a lot of path because they do have to have access to every garden, so maybe 30 per cent of it, yes.

PN11180  

Are there many trees in the facility?‑‑‑Not many.  There are trees in the car park, which are gum trees, and there's a couple of trees at the back, and that's it.  Because the buildings are so close to the edges of the property you can't have many trees.

PN11181  

Okay.  So most of the trees, the trees that are there are not ornamental trees that you're maintaining?‑‑‑No, not the gum trees anyway.

PN11182  

In terms of a typical garden layout are they native plants that are water resistant, what's the typical plant layout for a garden?‑‑‑For my garden a typical - where the trees are?

PN11183  

No, in the facility?‑‑‑I'm sorry, you're confusing me.  What did you mean by that question?

PN11184  

In the facility you've got a variety of garden beds, don't you?‑‑‑Yes.

PN11185  

Are they typically planted with native plants or are they planted with exotic - - -?‑‑‑No, no.  The owner of the facility likes the classic look.  She's not really keen on native plants, so they're more Mediterranean plants to ornamentals.  Lots of hedging.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11186  

By hedging you mean Buxus or Camellia, what sort of hedging?‑‑‑Tom Thumbs are my favourite, but we've used a very unusual plant along the back because it's cheap.  It's a Viburnum.  So that stretches along the entirety of the property at the back.

PN11187  

I take it from a maintenance perspective you're obviously -as you said before you're responsible for the watering of the garden?‑‑‑Yes.

PN11188  

I take it you're responsible for the fertilising of the garden?‑‑‑Yes.

PN11189  

And you do all the pruning?‑‑‑Yes.

PN11190  

And I take it if plants are unhealthy or dying you will replace them?‑‑‑If it's within budget, yes.

PN11191  

Who sets that budget?‑‑‑I had a chat with our budget guy two years ago and he told me not to go over $200, so I try not to go over that amount.

PN11192  

Bear with me, $200 a day, a week or a month?‑‑‑Two hundred dollars a month.

PN11193  

Is that your plant budget for the month or does it include other things?‑‑‑It includes everything that we order.  We order exclusively through Bunnings.  Anything that I deem that I need I order, and that's within the 200.  Anything else I have to make a special request.

PN11194  

Does that go to your manager?‑‑‑Yes.

PN11195  

What role does your manager play, what's their title?‑‑‑My immediate manager is the head chef.

PN11196  

Sorry, I did read that, I apologise - - -?‑‑‑Yes.  They didn't know what to do with my position, so I've come under her.  She doesn't really supervise me, so I'll go and mostly communicate with our CEO directly, either verbally or through paperwork.

PN11197  

Is that the person you described as the owner?‑‑‑No, she's our CEO.  Our owner, her name is Dr Gol.

PN11198  

Can I jump you around a little bit.  Can I just take you to paragraph 24?‑‑‑Yes.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11199  

In 24(d) where you say 'Rubbish collection' is that rubbish collection for the garden or is that rubbish collection for the facility?‑‑‑It's whatever's needed.  It's mostly rubbish I've collected or pruned off, whatever's around.  I do have bins around the entire grounds, and I'll go and check and see if they need emptying.

PN11200  

And I take it those bins are just what might be described as domestic bins for domestic waste, are they?‑‑‑Yes, but they're mostly utilised by myself.

PN11201  

They're bins that you will use from time to time if you're pruning or doing things like that?‑‑‑Yes.  Yes, pretty much when I'm working I have a bin with me and I fill it.

PN11202  

But then in (g) you say, 'Some forms of pest control.'  Which forms of pest control do you do?‑‑‑The indoor sections of the courtyards, they're indoor plants, so I'll control things like Mealybug, anything of those sorts, red spider mites, thrip, all those kind of things.  Outdoors I have treated the lawn for grub, which is nasty chemicals, but it's mostly to do with weed control, so it's things like glyphosate.  So - yes.

PN11203  

When you say nasty chemicals what are you referring to there?‑‑‑I can't remember the name of the chemical I used at the time, but you sprinkle it on the ground.  You have to have full PPE on.  I don't like doing it, (1) it stays in the soil, and (2) it freaks out the residents.  The first time I did it they thought that we'd had a nuclear bomb go off or something.

PN11204  

Was that because of how you looked?‑‑‑Yes, yes, full body suit over the head, goggles, gloves.  It was a bit much for them.  So I try not to use chemicals if possible.

PN11205  

Can I take you to paragraph 13, this is where you talk about designing a garden?‑‑‑Yes.

PN11206  

When you say design a garden are you saying you redesign the entire garden in the facility, or are you talking about a garden bed, or what are you talking about when you say - - -?‑‑‑In this example I designed the entire thing from get-go, because that was one of the extensions that had occurred, our last extension.  The existing garden was completely lawn, it was all lawn, and that was all ripped out.  So I had to design the entire thing.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11207  

So you've redesigned the garden for the facility?‑‑‑That particular garden, yes, and I've done a few others.  Because of how many extensions we've had the original gardens, there's not many of them left, so most of them are mine.

PN11208  

And you talk here about how you've structured the paths because of the residents?‑‑‑Yes.

PN11209  

I take it you didn't learn that in your Certificate II?‑‑‑A little bit.  There was also a course that I attended in the beginning of my working career with Gloucester to do with dementia.  That was very informative.  I've done a few dementia courses while I've worked there, but there was a booklet that was available online, and it probably still is.  I think it was called 'Dementia and Gardening in Aged Care.'  Such a good resource.  I pretty much copied the entire book.  So - yes.

PN11210  

That's just a publicly available book?‑‑‑Yes, yes.  I think it was the government supplied it.

PN11211  

Okay.  And that's where you mostly learnt to do what you've described in paragraph 7?‑‑‑Yes, and the girls will always answer questions who work with dementia, so I've learnt a lot off the girls.

PN11212  

When you say you copied the book you copied the ideas in the book?‑‑‑Yes, yes.  They will give a suggestion like have a plant with different textures, and then they will list off plants that have textures, so lamb's ears, if you know what that is.  It's a leaf that's furry and it's beautiful to touch.  So that was one of the plants that I've incorporated in the dementia ward.

PN11213  

And in paragraph when you talk about being careful not to have poisonous or dangerous plants did that come from the book as well or was that just - - -?‑‑‑No, that's just something that I've always made sure of.  Because of my childcare history I tend to treat the dementia people like children, which isn't a very good habit.  So, I've always made sure that there were no poisonous plants anywhere near the dementia ward.  And you tend to learn which plants are poisonous and which aren't after a while, so ‑ ‑ ‑

PN11214  

So, you transferred some of your learnings from a child care environment into your work ‑ ‑ ‑?‑‑‑Yes.  Yes.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11215  

You talk in your statement about your gardening club.  And I think you say in your statement that you're normally accompanied by a lifestyle person.  Is that a recreation and lifestyle officer who works at Gloucester or somebody else?‑‑‑It's diversional therapists is what their term is today.  Lifestyle is the old term.  I'm so old now I keep referring back to them in the old way.  That's an entire group.  I can't remember what they are.  They're a big part of - what's it called - lifestyle's a big part of - in themselves, whereas I'm in environment.  So what are they?

PN11216  

Am I right in saying that the diversional therapists will work with you to make sure that the involvement of residents in gardening meets their requirements in terms of the diversional therapy?‑‑‑Yes.  If it's going to be a one-on-one they usually make sure that they're able bodied, and can keep up with what I've planned to do with them, otherwise it's just a great big group and they just are on standby for taking people back for toileting and medication needs, so, yes.

PN11217  

The actual gardening activities you engage them in, what sort of gardening activities might you engage the residents in?‑‑‑One time I had a whole bunch of jars with bugs in them, and got to scare them silly with the bugs.  They love that.  Another time was I showcased all of our roses, and they were helping me identify what rose what was, talking about the different pests on different plants.  It varied on whatever I was doing at the time and what season it is.  If it's too cold, I can't really do much with them other than just get them all to sit there and listen to me talk, which they love to do anyway, yes.

PN11218  

Are there circumstances where you bring an external contractor in to work on regardless, or do you do everything yourself?‑‑‑No, we have done in the past where - it depends on who's been employed at the time.  New people come up with wonderful ideas, and they'll come and approach me.  On one particular occasion I said to them that I was too busy installing a whole new garden, so, they did contract out someone to do gravel and put in pots into a garden for me.  And another time when I was establishing the dementia garden, we did have a groundsman come in and do the ground work, so he put in the paving and the irrigation, and the sections of lawns that were destroyed he replaced them, and then the rest was left up to me.

PN11219  

You did the planting and things like that?‑‑‑Yes.  Yes, I did the planting, the designing, the planting, and any adjustments to the irrigation.

PN11220  

Again, when you did that dementia garden that's from the book you talked about?‑‑‑Yes.  Yes.

PN11221  

Do you order supplies?‑‑‑Yes.

PN11222  

Does that come from the Bunnings account as well?‑‑‑Yes, that's - yes, that comes through Bunnings.  So, I have to check the prices and add it all up, and submit it to my boss for them to approve it.

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11223  

Is that even if it's still under the $200 limit?‑‑‑Yes.  If it's under the $200 limit I just give it straight over to the finance person.  If it's over I have to give it to our CEO, and then they take it to the owner for her to approve it.

PN11224  

Just a moment.  Ms Wahl, thank you for your evidence.  No further questions, Commissioner.

PN11225  

COMMISSIONER O'NEILL:  Thank you.  Any re-examination, Mr Oski?

PN11226  

MR OSKI:  No re-examination, Commissioner.

PN11227  

COMMISSIONER O'NEILL:  Ms Wahl, look, thank you very much for your evidence this afternoon, and for being so flexible and being available earlier than planned.  You're excused and free to go?‑‑‑Thank you.

<THE WITNESS WITHDREW������������������������������������������������������������ [2.35 PM]

PN11228  

COMMISSIONER O'NEILL:  Now, I think we might - do we have Ms Grogan.

PN11229  

Ms Grogan, can you hear me?

PN11230  

MS GROGAN:  Hello, yes, I can.

PN11231  

COMMISSIONER O'NEILL:  Lovely.  Would you be able to turn your camera on?

PN11232  

MS GROGAN:  Yes, I can.  There I am.

PN11233  

COMMISSIONER O'NEILL:  Lovely, thank you for that.  I'm Commissioner O'Neill, and my associate is just going to take you through the affirmation.

PN11234  

MS GROGAN:  Okay.

PN11235  

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

***������� JANE NATASHA WAHL��������������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11236  

MS GROGAN:  Lillian Leanne Grogan, and my work address is 76 Morgan Street, Wagga Wagga.

<LILLIAN LEANNE GROGAN, AFFIRMED����������������������������������� [2.36 PM]

EXAMINATION-IN-CHIEF BY MR OSKI���������������������������������������� [2.36 PM]

PN11237  

COMMISSIONER O'NEILL:  Mr Oski.

PN11238  

MR OSKI:  Good afternoon, Ms Grogan, can you hear me okay?‑‑‑Yes, I can.

PN11239  

Excellent.  My name is Sheldon Oski.  I'm appearing on behalf of the UWU today.  Can you just repeat your full name for the record?‑‑‑Lillian Leanne Grogan.

PN11240  

Now, I understand you've made a statement for the purposes of the proceedings; is that right?‑‑‑Yes.

PN11241  

I understand the statement is dated 20 October 2021 and runs to 26 paragraphs over five pages?‑‑‑Mm-hm.

PN11242  

Do you have a copy of that statement with you right now?‑‑‑I do, yes.

PN11243  

Excellent.  And have you had an opportunity to read through it again recently?‑‑‑Yes.

PN11244  

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

PN11245  

Excellent.  Commissioner, that document is 243 at page 12159 of the digital court book, and we seek to rely upon that statement.

PN11246  

Now, Ms Grogan, you'll be able to see in one of the windows on your screen that there is a Nigel Ward on it?‑‑‑Okay.

PN11247  

He will now ask you some questions?‑‑‑Okay.

***������� LILLIAN LEANNE GROGAN�������������������������������������������������������������������������������������������������������������� XN MR OSKI

***������� LILLIAN LEANNE GROGAN��������������������������������������������������������������������������������������������������������� XXN MR WARD

CROSS-EXAMINATION BY MR WARD������������������������������������������ [2.38 PM]

PN11248  

MR WARD:  Ms Grogan, can you hear me okay?‑‑‑I can, Nigel.

PN11249  

Thank you very much.  My name is Nigel Ward, Ms Grogan.  I'm appearing in these proceedings for the employer interests, and I'm going to ask you some questions.  I'll do my best not to keep you too long this afternoon.  Do you have your statement in front of you?‑‑‑Yes, I do.  Yes.

PN11250  

Lovely.  Can I just start right at the beginning if I can, can you tell me what is a care worker coach?‑‑‑Okay, that's within my work role.  It's like a mentoring role, so, within care - as a care worker coach I go out with other care workers that are new to the job and give them some on-the-job - sign them off as an on-the-job training sort of thing.  Plus I also support existing care workers in their role if they are having any issues with client issues or other work related issues where they just want to talk to someone who does a similar job to what they do, so ‑ ‑ ‑

PN11251  

So, I take it that you - do you also have clients you look after yourself?‑‑‑Yes.  Yes, I do care worker and half of my contract is now doing coaching side of it, so, yes.

PN11252  

So, for want of a better way of putting it, half of your job is direct care ‑ ‑ ‑?‑‑‑Yes.

PN11253  

‑ ‑ ‑ and the other half you play the coach/mentoring role with other care workers?‑‑‑Yes.

PN11254  

And are you the only care worker coach or are there others?‑‑‑No, there are others.

PN11255  

Can I just - I just want to understand a little bit about you're structure, if I can.  As the care worker coach who's the person you call if you need help or assistance or guidance?‑‑‑Okay.  We have quite a few people we can call upon.  I have my supervisor - my people leader is my supervisor.  Then there's the branch manager.  We also have contact with the organisational head nurse who runs the coaching program, and we also � we have a team set up where we have channels with other coaches so we can call on each other for help as well.

PN11256  

Let's maybe go through those one-by-one if we can.  The people leader, is that the person who actually undertakes the initial assessment of a new client, is that what their job is?‑‑‑Yes.  They look after the customers, yes.

***������� LILLIAN LEANNE GROGAN��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11257  

So in a different context they might be called a case manager, is that sort of their role?‑‑‑Possibly, yes - - -

PN11258  

Or you might not know?‑‑‑We call them people leaders or service co's, yes, sorry.

PN11259  

So you also might call them service coordinators?‑‑‑Yes.

PN11260  

So if I was a new client of yours, my first point of contact would be with the service coordinator to set me up, would it?‑‑‑Yes.  I believe so, yes.

PN11261  

Is it those people who will prepare the initial care plan for me, or is it somebody else?‑‑‑No, I believe that's a service coordinator's job to do the care plans; yes, that we have to follow.

PN11262  

I appreciate that you're a senior person as a coach, but if you're out on the job and you need assistance, is your first point of call the service coordinator?‑‑‑Yes.

PN11263  

And I think you also said that there's � you say there was a head registered nurse, or a registered nurse?‑‑‑There's a registered nurse who runs the Department of Nursing for our organisation.

PN11264  

Is it the case then that if you're out with a client and you need clinical assistance, does that go to that person to organise clinical assistance, or does it go somewhere else?‑‑‑No, we do have � okay, we have a nurse that works in the branch level.  That nurse works under the head nurse, who I was referring to, who coordinates all of the training courses.  So as care workers, we have to have clinical training to go out onto the job, which comes under that head nurse's responsibility to make sure that the training modules are all up‑to‑date and things like that.  Does that make sense?

PN11265  

It does.  I just want to explore a word you used there.  You said you have 'clinical training'?‑‑‑Yes.

PN11266  

Can you just explain to me what you understand to be 'clinical training', because it might mean something very different to me?‑‑‑Okay.  So, like, monitoring blood glucose levels, bowel care, urinary care, medication.  What else do we do?  Stoma care we can do.  Yes, those sorts - - -

***������� LILLIAN LEANNE GROGAN��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11267  

That's fine.  I'll come back to medications in a moment, but I take it those are the subject of internal training that's run by the head nurse, is that what you were describing?‑‑‑Yes.

PN11268  

Are those internal training programs in addition to your Certificate IIIs or your Certificate IVs?‑‑‑Yes.

PN11269  

There's one there we haven't � I certainly haven't seen before in this case I just want to ask you some questions about.  One there, you said 'bowel care'?‑‑‑Mm‑hm.

PN11270  

I take it that you're trained to give enemas and things like that, are you, in Australian Unity?‑‑‑If needed, yes.

PN11271  

And it's the nurse who signs you off as competent to do that, is it?‑‑‑That's correct, yes.

PN11272  

And that's a qualification you've personally got?‑‑‑Yes.

PN11273  

I take it with blood sugar, that would be sort of the finger prick to test blood glucose?‑‑‑Yes.  Yes, monitoring the sugar levels.

PN11274  

And again, you have to be signed off by the nurse to do that as well, do you?‑‑‑That's correct, yes.

PN11275  

Then when you said 'medications', I take it you've done a medication course for medications?‑‑‑Yes, just using � we can only distribute medications out of a blister pack.

PN11276  

Bear with me, it's my understanding that that would be Schedule 4 medications, not Schedule 8, is that correct?‑‑‑I don't know what Schedule 8 is, so I'm assuming.

PN11277  

That's fine.  And when you say, 'We're only allowed to distribute them from a Webster‑pak', is this the case, that you don't actually administer the tablets but you can remove them from the Webster‑pak, put them in a cup to prompt the client to take the tablet?‑‑‑That's correct, yes.

***������� LILLIAN LEANNE GROGAN��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11278  

I take it that that training also allows you to do eye drops and ear drops and things like that?‑‑‑Yes.  It does, yes.

PN11279  

You also talked about catheters.  Do you have clients with catheters at the moment?‑‑‑I don't at the moment, no.

PN11280  

Have you in the past though?‑‑‑Yes.

PN11281  

Am I right that the actual placement of the catheter would be a clinical job that you'd need the RN to do?‑‑‑That's correct, yes.  We just care for the � making sure the site's clean, reporting back if things don't look right.  We change the bag - empty the bag, night bag; put it in day/night bags, and all those sorts of things to help people, you know, go to bed, be clean, but we don't actually, you know, insert the catheter into - - -

PN11282  

Right?‑‑‑Yes.

PN11283  

I just want to understand what your procedures are in Australian Unity.  I'm just going to take you through some examples just to see what your procedures are.  Let's say that I was your client and you were showering me and you observed a skin tear on me, is it your procedure that that has to be reported?‑‑‑Yes.

PN11284  

And does that go to your service coordinator or does that go to the nursing staff?‑‑‑Probably go to the service coordinator, who then would pass it on to the nursing staff.

PN11285  

Yes?‑‑‑Yes, that's my understanding.

PN11286  

Would the same be the case if you noticed sort of bruising or bed sores or things like that?‑‑‑Yes, all goes straight back to the service coordinator as the first point of reporting to, yes.

PN11287  

But let's assume that things get worse and let's say I have a fall; what's the procedure if I was to have a fall?‑‑‑We have to call an ambulance straightaway, and you know, follow the direction of the Triple 0 call, and then report back to the office directly straightaway once it's happened.

***������� LILLIAN LEANNE GROGAN��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11288  

Yes?‑‑‑And we're not allowed to pick anyone up or move anyone under any circumstances basically.  We just have to report what we see, call the ambulance.  Even if the client doesn't want us to call an ambulance, we still � that's what we have to do.

PN11289  

You call it anyway?‑‑‑Yes.

PN11290  

Does the service coordinator contact the family to explain what's happened?‑‑‑I would assume so, yes.

PN11291  

You're not sure?‑‑‑I hope so.

PN11292  

No, that's fine.  You hope so?‑‑‑Yes, I think they do.

PN11293  

Is there something similar if you arrive and sort of nobody's home, is there a procedure for that?‑‑‑Yes, the non‑response.

PN11294  

Yes?‑‑‑You have to report that.  We can't leave the client's home until we have contacted the office and reported it to them, and we have to wait for them to either contact that person's emergency contact before we can leave, and they'll get back to us and say no, it's okay for you to go on to your next job or something like that.

PN11295  

When you finish with a client, do you � obviously you do make progress notes.  Do you make them � some people said they make them in a book; some people said they put them into an app.  What do you do?‑‑‑Yes, we have a Procura.  We use Procura app, where there is � we put in dated notes after every service.  We also have other apps to report incidences, hazards called DoneSafe.

PN11296  

Yes?‑‑‑That goes � that's a more official sort of way of reporting, because it goes to our service co first and then to - our branch manager can also see that, so the hierarchy can actually see what's going on.

PN11297  

So if you were at a residence, at a client's house and there was something unsafe that you'd observed that goes into DoneSafe and gets escalated quickly?‑‑‑Yes.

PN11298  

If you finish a visit to a client do I take it you have to record something in Procura or do you only record if it's sort of an exception to the norm?‑‑‑Well, it's a bit of a grey area.  Sometimes I like to put something in there every time.  It depends on the care plan, how up to date their care plan is, or if something's changed from their care plan then I always report things back that we may have done that's not actually in their care plan, so that they know that that's a regular thing.  But most of the time there is a (indistinct) note at the end of the service, yes.

***������� LILLIAN LEANNE GROGAN��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11299  

And I take it that the Procura system operates so that if I was the carer after you I could log on and find out what happened?‑‑‑Yes.

PN11300  

Am I right that when the service coordinator sets up the resident they do a risk assessment of the house?‑‑‑Yes.

PN11301  

I take it you don't get involved in that?‑‑‑Well, look, I've worked in aged care now for quite some time.  We used to always do an annual review, workplace review.  We do get involved in risk assessments in that we are risk assessing every time we go into someone's house because it changes from one visit to the next.  So it is our responsibility to always report back anything that's changed within that household or within that dwelling, within that person's conditions or whatever.  So I would say we're very involved in risk assessing because we do it every day.

PN11302  

That's fine.  Every time you go in you've got your mind focused on whether or not the risk environment has changed and if it has you record stuff in DoneSafe?‑‑‑Yes, exactly, and (indistinct) notes, yes, or email, whichever (indistinct) really, yes.

PN11303  

And I appreciate that from time to time do you find yourself in a situation that's unsafe?‑‑‑I've been pretty lucky, I don't think I've felt too unsafe within my workplace.  Sometime - I have had some clients with behavioural issues, which can be a bit scary at times.  Sometimes late in the night time service you might feel a bit unsafe walking to the car in the dark, but I have been - nothing has happened, which has been lucky.

PN11304  

No, that's good to hear.  I take it that if - do you have a procedure if you do feel unsafe?‑‑‑Yes, well, like we can report that to again - but after hours we do - now we do have an after hours call number, which we never used to have, so that's an improvement, but I guess the procedure is to try and not - just be able to just leave if you can, if it's an unsafe house.  Like if you feel like you're being - going to be attacked by someone, you know, try and just get out of the house.

PN11305  

Is that the rule that you have to leave the house?‑‑‑I would.

PN11306  

So you don't know if there's a rule?‑‑‑I'm not sure.  No, I'm pretty sure if you're - if you're being threatened you should go, yes.

PN11307  

But that's never happened to you, you've never had to do that?‑‑‑No.

***������� LILLIAN LEANNE GROGAN��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11308  

Now, you've got both your Certificate III and Certificate IV and you're also a coach.  So I get to ask you an interesting question.  Is the Certificate III sufficient to do the job in your opinion as a coach?‑‑‑My Certificate III was in Aged and Community Care which I did quite a few years ago.  Yes, I think it's sufficient, yes.  We do have ongoing training which were - we had lots of modules, so we're updating all the time.  So it's not just based on that certificate, the coaching.

PN11309  

So your in-house training is of use to you as well?‑‑‑Yes, definitely, yes.

PN11310  

But you went on to do your Certificate IV?‑‑‑Certificate IV?

PN11311  

You've done Certificate IV modules, is that right?‑‑‑Some modules, yes, that was in the training and assessing.  That was before Australian Unity.  I did some work health and safety training.  There used to be a registered training organisation back when the state run home care, so we did some workplace assessing modules back then to help people do the Certificate III.

PN11312  

It wasn't Certificate IV in aged care modules?‑‑‑No, it was workplace assessing, yes.

PN11313  

No, that's fine.  Just a couple of things if I can.  You talk at paragraph 16 about palliative care needs?‑‑‑Yes.

PN11314  

And then you say at paragraph 18, 'Our skills therefore range from dusting shelves to helping someone die'?‑‑‑Yes.

PN11315  

Probably not the best choice of words, we're not actually administering something to help someone die.

PN11316  

I didn't read them that way.  But don't be stressed, Ms Grogan, I didn't read it in that way.  Have you got palliative patients at the moment, palliative clients?‑‑‑No, not at the moment I don't, no.

PN11317  

But you've had them previously in your career?‑‑‑Yes.

PN11318  

I take it that when you were dealing with those people you're still doing your care support role, you're not doing the role of a registered nurse or something like that?‑‑‑No.  Yes, the care support role, that's correct, yes.

***������� LILLIAN LEANNE GROGAN��������������������������������������������������������������������������������������������������������� XXN MR WARD

PN11319  

And I take it that in those situations you might come into contact with their nurse or their GP?‑‑‑Usually the palliative care nurse is the people that we have most contact with over the years, because they will come in and lay the plan of care out for that person, and our role in that part, yes.

PN11320  

Are they employed by Australian Unity or are they community service or - - -?‑‑‑Community service usually, yes.

PN11321  

Just lastly if I can; when you do your little risk assessments when you go in does your organisation describe that as a Take 5 risk assessment?‑‑‑I haven't heard that term before.

PN11322  

Okay, that's fine.  I will let Australian Unity know that the people don't know the proper name.  That's fine.  Ms Grogan, thank you for your evidence.  Commissioner, no further questions.

PN11323  

COMMISSIONER O'NEILL:  Any re-examination?

PN11324  

MS DOUST:  Commissioner, I had a question in cross-examination.

PN11325  

COMMISSIONER O'NEILL:  All right.

CROSS-EXAMINATION BY MS DOUST������������������������������������������ [2.57 PM]

PN11326  

MS DOUST:  Ms Grogan, my name is Lisa Doust, I'm not sure if you can see me, but can you hear me?‑‑‑Yes, I can.

PN11327  

I appear for the Health Services Union in this matter.  You just gave some evidence before where Mr Ward asked you about removing yourself in a circumstance where you felt unsafe.  Do you recall being asked those questions?‑‑‑Yes.

PN11328  

And I think one of the answers you gave was that you had been in some situations where it had been pretty scary.  Is that right?‑‑‑Yes, a while ago, yes.

***������� LILLIAN LEANNE GROGAN������������������������������������������������������������������������������������������������������� XXN MS DOUST

PN11329  

Tell me about the circumstances where you felt scared or unsure doing your work?‑‑‑Okay.  It was probably back when we were working with disability cases at one stage and there was a client which had physical aggressive behaviours towards carers, so - and could never really tell when that was going to happen, so it was always sort of being on guard a little bit.  Luckily like I said nothing really did happen which is detrimental to my health, but there was always a potential for something to happen.

PN11330  

All right.  Thank you for that?‑‑‑No worries.

PN11331  

Nothing else, Ms Grogan, thank you.

PN11332  

COMMISSIONER O'NEILL:  All right.  You said there was nothing in re-examination, Mr Oski?  Mr Oski, I think you might have frozen.  Just give him a moment just to rejoin.

PN11333  

Mr Oski, how's the line this time?  There you go.

PN11334  

MR OSKI:  Apologies, I was having some technical difficulties.  Is everyone able to hear me?

PN11335  

COMMISSIONER O'NEILL:  Yes.

PN11336  

MR OSKI:  I'm having problems, I can't hear any of you.  However, I can say I don't have any further questions or re-examination at this time.

PN11337  

COMMISSIONER O'NEILL:  Ms Grogan, thank you very much for your evidence this afternoon and you're excused and free to go, so thank you?‑‑‑Thank you.

<THE WITNESS WITHDREW������������������������������������������������������������ [3.01 PM]

PN11338  

COMMISSIONER O'NEILL:  Mr Oski, do you want to have another go at leaving and rejoining and see if that corrects itself?  How's that, Mr Oski, can you hear us now?  Oh dear, that's not promising.  You can't even shake your head.  Well, this might just about take us through until 4 o'clock, I think, which is when the next witness is available.

PN11339  

MR WARD:  Sorry, Commissioner, who's the 4 o'clock witness?

PN11340  

COMMISSIONER O'NEILL:  I think it was Susan Toner.

***������� LILLIAN LEANNE GROGAN������������������������������������������������������������������������������������������������������� XXN MS DOUST

PN11341  

MR WARD:  Commissioner, can I make the suggestion, could we maybe adjourn for 10 minutes and in the spirit of this case I'll review whether or not we need to call Ms Toner given Mr Oski's dilemma.

PN11342  

COMMISSIONER O'NEILL:  I think that's a lovely idea.  We'll adjourn until 3.15.

PN11343  

MR WARD:  Thank you, Commissioner.

PN11344  

COMMISSIONER O'NEILL:  Thank you.

SHORT ADJOURNMENT�������������������������������������������������������������������� [3.04 PM]

RESUMED����������������������������������������������������������������������������������������������� [3.15 PM]

PN11345  

COMMISSIONER O'NEILL:  The Commission has resumed.  Can you hear us this time?

PN11346  

MR OSKI:  Yes, I can.  Can you hear me?

PN11347  

COMMISSIONER O'NEILL:  Yes, we can.

PN11348  

MR OSKI:  Sincere apologies for that.

PN11349  

COMMISSIONER O'NEILL:  No, no, these things happen.  Mr Ward, how did you go?

PN11350  

MR WARD:  I don't think this case is going to turn on Ms Toner's evidence, Commissioner.  We don't require Ms Toner for cross-examination.  If that gets me an early mark this afternoon, I'm prepared to take that position.

PN11351  

COMMISSIONER O'NEILL:  I think it certainly gets you brownie points of some kind.  So, Mr Oski, having resolved your technical difficulties they are now not needed, as Ms Toner won't be required, but I don't think you'll complain about that.

PN11352  

Unless there's anything anyone wishes to raise, we will adjourn until - I think we're scheduled for 9.30 tomorrow morning.

PN11353  

MR WARD:  If the Commission pleases.

PN11354  

COMMISSIONER O'NEILL:  Thank you all.

PN11355  

MR OSKI:  If the Commission pleases.

PN11356  

COMMISSIONER O'NEILL:  The Commission is adjourned.

PN11357  

MR McKENNA:  Thank you, Commissioner.

ADJOURNED UNTIL WEDNESDAY, 11 MAY 2022 ���������������������� [3.16 PM]


LIST OF WITNESSES, EXHIBITS AND MFIs

 

SUSANNE WAGNER, AFFIRMED................................................................ PN10219

EXAMINATION-IN-CHIEF BY MS DOUST................................................ PN10219

CROSS-EXAMINATION BY MR WARD..................................................... PN10232

RE-EXAMINATION BY MS DOUST............................................................ PN10333

THE WITNESS WITHDREW......................................................................... PN10376

PAULA GRACE WHEATLEY, AFFIRMED................................................ PN10385

EXAMINATION-IN-CHIEF BY MR OSKI................................................... PN10385

CROSS-EXAMINATION BY MR WARD..................................................... PN10399

THE WITNESS WITHDREW......................................................................... PN10460

NGARI INGLIS, AFFIRMED.......................................................................... PN10474

EXAMINATION-IN-CHIEF BY MR OSKI................................................... PN10474

CROSS-EXAMINATION BY MS RAFTER.................................................. PN10484

THE WITNESS WITHDREW......................................................................... PN10530

TERESA HETHERINGTON, AFFIRMED................................................... PN10543

EXAMINATION-IN-CHIEF BY MR OSKI................................................... PN10543

CROSS-EXAMINATION BY MR WARD..................................................... PN10551

THE WITNESS WITHDREW......................................................................... PN10623

CATHERINE ELIZABETH GOH, AFFIRMED........................................... PN10637

EXAMINATION-IN-CHIEF BY MR OSKI................................................... PN10637

CROSS-EXAMINATION BY MR WARD..................................................... PN10647

THE WITNESS WITHDREW......................................................................... PN10739

SUSAN MARY MORTON, AFFIRMED........................................................ PN10767

EXAMINATION-IN-CHIEF BY MS OSKI................................................... PN10767

CROSS-EXAMINATION BY MR WARD..................................................... PN10777

THE WITNESS WITHDREW......................................................................... PN10859

MARIA MOFFAT, AFFIRMED..................................................................... PN10881

EXAMINATION-IN-CHIEF BY MR OSKI................................................... PN10881

CROSS-EXAMINATION BY MR WARD..................................................... PN10891

THE WITNESS WITHDREW......................................................................... PN10964

IRENE MARY MCINERNEY, AFFIRMED.................................................. PN10975

EXAMINATION-IN-CHIEF BY MR MCKENNA........................................ PN10975

CROSS-EXAMINATION BY MR WARD..................................................... PN10999

RE-EXAMINATION BY MR MCKENNA.................................................... PN11098

THE WITNESS WITHDREW......................................................................... PN11107

JANE NATASHA WAHL, AFFIRMED......................................................... PN11129

EXAMINATION-IN-CHIEF BY MR OSKI................................................... PN11129

CROSS-EXAMINATION BY MR WARD..................................................... PN11140

THE WITNESS WITHDREW......................................................................... PN11227

LILLIAN LEANNE GROGAN, AFFIRMED................................................ PN11236

EXAMINATION-IN-CHIEF BY MR OSKI................................................... PN11236

CROSS-EXAMINATION BY MR WARD..................................................... PN11247

CROSS-EXAMINATION BY MS DOUST..................................................... PN11325

THE WITNESS WITHDREW......................................................................... PN11337