PN954

COMMISSIONER O'NEILL: Good morning everybody. I understand in terms of the appearances this morning there's just one change, that's Mr or Ms Oski for the UWU. Are there any other changes? No. Good. All right. Now, before we get started with the witness evidence this morning, are there any issues any party wishes to raise?

PN955

MR GIBIAN: I don't believe so on our part. I can give an overview of the witnesses that are proposed for today because there's been a couple of slight changes at a convenient time, Commissioner, but otherwise I don't think there's anything I was going to raise.

PN956

COMMISSIONER O'NEILL: All right. Well, then the only other matter I was going to suggest, just so that we can maximise the chance of moving through the day as seamlessly as possible, Mr Gibian, if your instructors can arrange for at least the next witness in line to be in the hearing room early, so that if we need to we can move quickly to the next witness.

PN957

MR GIBIAN: We'll endeavour to do that as best we can, Commissioner.

PN958

COMMISSIONER O'NEILL: All right then. So, Mr Gibian.

PN959

MR GIBIAN: Yes. Well, thank you, Commissioner. I think - I assume that you've received the list of the witnesses who were proposed for the day, the total and the order that were proposed. There were 12 that were scheduled. The two changes to that are that the final witness who was scheduled for 4 o'clock, Tracey Roberts, we were advised last evening that she's no longer required for cross-examination. And secondly that the witness scheduled - who had been scheduled for 2 o'clock, Alison Curry, we were asked that - or it was communicated by Mr Ward or his team that they were not prepared for the cross-examination - for her cross-examination today. She had been a somewhat late addition, I think, to the list for today and in those circumstances we're content for her to be rearranged for a time next week, which would leave 10 witnesses which I'm sure will probably be enough to go on with.

PN960

COMMISSIONER O'NEILL: All right. In light of Ms Curry not giving evidence today, is it possible to move forward Ms Gauci and the remaining witnesses for this afternoon?

PN961

MR WARD: Commissioner, can I assist in that. I suspect I'm going to be a little longer than anticipated with some of the early ones and then I'm going to get quicker as we go through, so it's more likely that we'll need the best part of the day for the group but you'll probably find I'll need more time with some and less time with others. So it's possibly not the - - -

PN962

COMMISSIONER O'NEILL: All right.

PN963

MR WARD: It's possibly not the case that we can bring them all forward.

PN964

COMMISSIONER O'NEILL: All right. Well, we'll leave it as it is then and - but if Mr Gibian can endeavour to have the next witness available, at short notice at least, that would be helpful. All right, Mr Gibian, ready to call - - -

PN965

MR GIBIAN: The only other thing I was going to add in terms of practicalities of the witnesses, some of them do have other time commitments, work and the like but - so we'll - but we'll endeavour to be as flexible as we can obviously but if some witnesses run a bit longer it may be necessary to adjust the order slightly, just based upon practical issues and I hope that won't cause any inconvenience to anyone. But these are the witnesses that are available today at least, or have been made available today at least.

PN966

The final matter I was going to raise in that regard is just to communicate there are some of those witnesses who have come into the HSU offices, which is where I physically am, but they will be sitting in a different room at the time that they are giving their evidence. Other of the witnesses will be remote, purely for geographical reasons, and to avoid unnecessary travel and logging in either from a work location or a phone location, there is perhaps greater potential for some kind of technological issues in that respect but we'll just try and deal with those as best we can, and we've tried to ensure that there is an appropriate connection and that it's all been set up such that it can work hopefully as - well, seamless might be overly ambitious but at least as efficiently as possible.

PN967

COMMISSIONER O'NEILL: All right then.

PN968

MR GIBIAN: The first witness then that was on the list, unless there's anything else that anyone else needs to raise is Mark Castieau. He is in the office in another room and I assume will be logging on now. We're just getting him to log in now. We were provided with some documents via Mr Ward not long ago, relevant to Mr Castieau's cross-examination and we're just arranging - they're not available to him immediately, we're just arranging for them to be printed and they'll be with him momentarily.

PN969

COMMISSIONER O'NEILL: All right.

PN970

MR GIBIAN: Thank you, Commissioner - I think Mr Castieau has now logged in.

PN971

COMMISSIONER O'NEILL: Good morning, Mr Castieau. My name is Commissioner O'Neill. My associate is just going to have you take the affirmation and then there'll be some questions for you.

PN972

MR CASTIEAU: Okay.

PN973

THE ASSOCIATE: Mr Castieau, can you please say your full name and work address?

PN974

MR CASTIEAU: Mark (indistinct) Castieau, I work at St Vincent's Care Services at Bronte. I'm not quite sure of the street address. It's in Bronte Road in Bronte.

<MARK CASTIEAU, AFFIRMED�� [9.38 AM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [9.38 AM]

PN975

COMMISSIONER O'NEILL: Right, thank you, Mr Castieau. Mr Gibian, did you have any matters at this point - any questions?

PN976

MR GIBIAN: Commissioner, I was just going to ask Mr Castieau to adopt the statements that have been filed, if that's convenient. Mr Castieau, can you just repeat your full name for the record please?‑‑‑Mark William Castieau.

PN977

You're employed as a chef at St Vincent's Care. it says in your statement Edgecliff. I think you said in Bronte, is it?‑‑‑Yes, I worked at Edgecliff and then I transferred to Bronte in August.

PN978

August of 2021?‑‑‑That's right

PN979

I understand - and that was after, obviously, the first statement was prepared and filed which was I think dated 29 March last year. I understand?‑‑‑Yes.

PN980

Now, you've made two statements for the purposes of the proceedings. The first of those was dated 29 March 2021, the text of which - the statement alone runs to 11 paragraphs and 108 paragraphs, sorry, over 11 pages. You have your copy of that with you, I think, do you?‑‑‑Yes.

***�� MARK CASTIEAU�� XN MR GIBIAN

PN981

Commissioner, I think you will presumably know already that's at document 181 in the digital court book, commencing at page 10625. You've had an opportunity to read that statement, have you, Mr Castieau?‑‑‑Yes. I've read it several times.

PN982

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

PN983

We tender - if that's the right word - or seek to rely upon the document at - the statement at document 181 in the digital court book.

PN984

COMMISSIONER O'NEILL: Thank you, I don't think we need to mark them separately. We've got the reference in the hearing book.

PN985

MR GIBIAN: Yes, I took it from the president's indication the other day that I would just identify them by reference to document and page number as we go.

PN986

COMMISSIONER O'NEILL: Yes.

PN987

MR GIBIAN: Mr Castieau, there was a reply statement then as well dated 20 April 2022 that runs to four pages and 29 paragraphs. You have that document as well?‑‑‑Yes.

PN988

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

PN989

So in addition we tender or rely upon the statement at document 182 in the court book, commencing at page 10688.

PN990

COMMISSIONER O'NEILL: All right.

PN991

MR GIBIAN: Mr Castieau, Mr Ward, who you'll see in one of the boxes on the screen, I think with his name appearing, will now ask you some questions.

CROSS-EXAMINATION BY MR WARD�� [9.41 AM]

PN992

MR WARD: Mr Castieau, am I pronouncing your name correctly?‑‑‑Yes, thank you for that.

***�� MARK CASTIEAU�� XXN MR WARD

PN993

My name is Nigel Ward, Mr Castieau, and I appear in these proceedings for the employer interests in the case. I'm going to ask you some questions, sir. If I ask you a question and you don't know the answer to it, just tell us. I don't want you to try and answer something you don't feel you're able to answer?‑‑‑Okay.

PN994

Can I just start - you say in your statement at paragraph 12 - sorry, 11 and 12 - do you have that in front of you?‑‑‑Yes.

PN995

The first one?‑‑‑Yes.

PN996

You say: 'I understand that my employment is covered by an enterprise agreement'. Then you say: 'I'm employed as a care services employee and paid in accordance with the classification care services employee grade 4'. Do you see that?‑‑‑Yes, yes.

PN997

We sent you a copy of an enterprise agreement this morning. Do you have a copy of that in front of you?‑‑‑Yes.

PN998

It's headed, 'St Vincent's Care Services New South Wales enterprise agreement'?‑‑‑Yes.

PN999

Do you understand that to be the agreement that covers you?‑‑‑Yes.

PN1000

If I could just by way of clarification - could you go to page 66 of 81 - - -?‑‑‑Sorry, 66?

PN1001

Yes, please - have you go that?‑‑‑I can't find it.

PN1002

Okay, if you look at the bottom right - - -?‑‑‑Unless it's - 66?

PN1003

Yes?‑‑‑I've got 66 of 67.

PN1004

I'm not sure why you have that but let's just see - - -

PN1005

COMMISSIONER O'NEILL: That's what I have. If you're referring to the relevant classification description, Mr Ward, I think you'll find it's page 61 of the version that has been sent through this morning?‑‑‑Okay.

***�� MARK CASTIEAU�� XXN MR WARD

PN1006

MR WARD: Bear with me, Commissioner. Commissioner, I'll come back to that because that doesn't accord with the document I have for the witness?‑‑‑I've got page 61 now.

PN1007

My problem, Mr Castieau, is I don't have you on page 61. I think we've sent you the wrong agreement, actually, Mr Castieau.

PN1008

COMMISSIONER O'NEILL: It's the previous version.

PN1009

MR WARD: Does your page 61 have, 'Care services employee grade 4'?‑‑‑No, it's got clerical grade 4.

PN1010

Okay - Commissioner, Mr Castieau, I apologise. I've done something in error. Please, we'll come back to that. Sorry, sir. I sent you a different document which is an Australian Government document, SIT30816, Certificate III in commercial cookery. Do you have that?‑‑‑Yes.

PN1011

Now, you say in your statement you did your commercial cookery Cert III in 1996, is that correct?‑‑‑That's right.

PN1012

When you did that, Mr Castieau, was there a practical element as well?‑‑‑Yes, yes.

PN1013

How long was the practical element for?‑‑‑I did an apprenticeship that took four years but two-and-a-half years I went to college one day a week and the college was both practical and - it was practical and the other.

PN1014

So in 1996 it was a full four-year apprenticeship, was it?‑‑‑Yes.

PN1015

I don't expect you to have seen the document I've sent you before. This is the current version of your qualification?‑‑‑Okay.

PN1016

Can I ask you to turn to the first page, which actually says page 2 of 6. Can you turn to that?‑‑‑Yes.

PN1017

You'll see down the bottom of the page it says, 'Core units'?‑‑‑Yes, it's changed since then - the curriculum has changed a lot since then.

***�� MARK CASTIEAU�� XXN MR WARD

PN1018

That's fine, this is what I'm interested to understand, if I can. Could I just ask you to turn your eye down the core units, which go over to the next page? I just wanted to know, is that similar to the program you did in '96 or is it dramatically different?‑‑‑That's very similar.

PN1019

Very similar - thank you, sir, thank you. Now, in your statement you say also that you have at paragraph 5C you have a Certificate in Food Handling and Food Safety. You also say at C you have a Certificate in Food Safety Supervising. Do you see that?‑‑‑Yes.

PN1020

If you could just help us clarify those: tell me is this is wrong, if you could, Mr Castieau, the Food Safety Supervisor course - - -?‑‑‑Yes.

PN1021

- - - my understanding is that's currently an online course, is that right?‑‑‑It's an online course, yes.

PN1022

And I'm informed that it involves six hours of combined reading or online learning. Does that sound right?‑‑‑Yes, that sounds right.

PN1023

Good, I might have the right one. And there's a practical element as well which is normally done over three shifts of four hours. So there's 12 hours of practical. Does that sound right?‑‑‑Practical?

PN1024

Yes?‑‑‑No one came and did it. I didn't do any practical element of that, it was just all online.

PN1025

So you didn't do a practical element, but you did the six hours online?‑‑‑Yes.

PN1026

Okay. No, that's fine. That's fine. The certificate in food handling and food safety is that an online course?‑‑‑No, visually someone would come to the facility and give a course and it would take a few hours and then you had a test on that. They do that every year.

PN1027

Is that two hours they come and do the course for?‑‑‑It sounds about right, yes, about two hours.

PN1028

And you do a test at the end?‑‑‑Yes.

***�� MARK CASTIEAU�� XXN MR WARD

PN1029

How long does it take to do the test; is it multiple choice?‑‑‑Multiple choice and some answers as well, some written answers.

PN1030

I take it you passed?‑‑‑Yes. I mean I've done hundreds of them.

PN1031

Can you go to paragraph 30 of your first statement. I'm just going to stay with the first statement for now?‑‑‑Okay. Yes.

PN1032

Paragraph 30 says this:

PN1033

St Vincent's has national set menus which are created in consultation with dieticians and speech pathologists. They provide those menus to me and I alter them depending on the resident's needs. We have been using the current menu for approximately two years.

PN1034

Do you see that?‑‑‑Yes.

PN1035

Can you just help us understand, when you say the menu has been set for two years are you saying that what we serve on Mondays is always the same, what we serve on Tuesdays is always the same, what do you mean by the menu set for two years?‑‑‑Well, two years ago they gave us a menu that was sent to us and we had to follow that with amendments to suit our residents - - -

PN1036

So when you say the menu set what you're allowed to cook is set for two years, is it?‑‑‑Yes. We've had that menu for two years.

PN1037

Right. So it will tell you that you can cook a pork dish or a beef dish and what's involved in it?‑‑‑Yes.

PN1038

And that will include the vegetables that are in it and things like that?‑‑‑Yes, and it has the recipes as well. But like if nobody eats pork I'm not going to make pork.

PN1039

I will come to that. So you weren't involved in writing that menu, that's done in head office, is it?‑‑‑Yes.

PN1040

And you say that it's created in consultation with dieticians and speech pathologists. Is it your understanding that dieticians signed it off?‑‑‑Yes, and if I amended our dietician will look at that and see if it's okay.

***�� MARK CASTIEAU�� XXN MR WARD

PN1041

So if you say, 'I'd like to serve this to this particular resident' the dietician has to approve that?‑‑‑Broadly speaking, yes.

PN1042

If you go to paragraph 38 you say:

PN1043

I am also provided with an approved pantry list which provides me with a list of items I can buy.

PN1044

I take it that because the menu is set what you need to buy for the recipes is also set?‑‑‑Yes.

PN1045

And that's what you mean by the pantry list, is it?‑‑‑Yes. Yes. They make a contract with a supplier and we're contracted to buy those things, like they set a price for that. That's - that's in the contract we can supply it - - -

PN1046

So that supplier is negotiated by head office?‑‑‑Yes.

PN1047

Where you say 'provides me with a list of items I can buy' what do you mean by you buying them, you order them?‑‑‑Yes.

PN1048

And that is you're ordering things that are on the set list of what you need?‑‑‑That's right. Yes, that's right.

PN1049

Can I take you quickly to paragraph 82?‑‑‑Yes.

PN1050

In 82 you're talking about what I think is some software applications, is that right?‑‑‑That's right.

PN1051

In 82(b) you say this:

PN1052

Integra the software is used to check stock levels and order directly from suppliers when required.

PN1053

?‑‑‑Yes.

***�� MARK CASTIEAU�� XXN MR WARD

PN1054

I am just trying to understand how this works. As you use ingredients does the software calculate what needs to be replenished?‑‑‑No, it's if the supplier's had it in stock. That's what I mean there.

PN1055

Okay. So you're checking the stock levels after you use things?‑‑‑Yes, I check it all again, checking it continually.

PN1056

You check it continually, and you will determine that you need to place an order for custard powder or whatever?‑‑‑Yes.

PN1057

And you then go to the stock list and you ask the supplier who's been negotiated for you to provide what you need?‑‑‑Yes, that's right.

PN1058

And how does the software help you with that, or how does it work with that?‑‑‑Well, if we don't have it in stock - if we don't have it in stock someone will tell me, someone will ring up - - -

PN1059

Okay. So that software allows you to see if the supplier has it in stock?‑‑‑Not exactly. If they don't have it in stock the supplier will contact me. If I put in an order and they don't have anything in stock someone will give me a ring and say, 'We don't have that, but we have this.' You know, they have alternatives if something's not in stock.

PN1060

Thank you. Can I take you - could you go to paragraph 44. I think you were talking about this a minute ago. You say:

PN1061

On any ordinary day I usually make one main meal for lunch and one main meal for dinner. I also prepare alternative choices if people do not wish to eat in the main kitchen.

PN1062

Do you see that?‑‑‑Yes.

PN1063

Let's perhaps use a meal as an example. Let's say that your main meal for lunch was a pork roast - - -?‑‑‑Yes.

PN1064

- - - would you do one of those occasionally?‑‑‑Yes. Yes.

***�� MARK CASTIEAU�� XXN MR WARD

PN1065

Okay. Right, good. We saw a very lovely pork roast on the inspection the other day. When you say, 'I prepare alternatives', I take it that's a resident who has actually said, 'I don't want that', is that - - -?‑‑‑That's right.

PN1066

Or is it the case that the resident might not simply eat it?‑‑‑They've said they don't want it because - you make an alternative, a few dishes of an alternative anyway in case someone doesn't like it. If someone doesn't eat pork I'll cook some other kind of meat instead.

PN1067

Okay. So there will still be a substitute meat like a beef or a lamb?‑‑‑But this is - when I worked at St Vincent's in Edgecliff since then it's changed and they have an alternative every day you cook regardless. So it's changed now, but this is what happened when I was working there. That's changed since then.

PN1068

So when you say you provide an alternative meal when you were at Edgecliff you would have some ready to go in case somebody didn't want the pork?‑‑‑That's right.

PN1069

I'm just going to concentrate on Edgecliff because that's your evidence. When you were at Edgecliff how many people worked underneath you, how many people worked for you?‑‑‑Well, there was - there was two people on in the morning, two people besides me, and two people in the afternoon, and I'd spend a couple of hours by myself.

PN1070

Were those people cooks or were they something else?‑‑‑No, they were kitchen hands or care service employees, or what do you call them, catering assistants.

PN1071

When you were at Edgecliff, how many lunches would you prepare each day?‑‑‑There were 39 people there.

PN1072

I take it the same for dinner?‑‑‑Yes.

PN1073

Did you normally cook a hot lunch and a hot dinner, or was dinner normally not a hot dinner?‑‑‑Dinner was � you had a hot meal for dinner, but also cold alternative � sandwiches and salads, and there's always soup every time.

PN1074

Could I take you to paragraph 36, if you could?‑‑‑36?

PN1075

Yes. Do you see that?‑‑‑Yes.

***�� MARK CASTIEAU�� XXN MR WARD

PN1076

You say, 'I adhere to the changes in line with the international standards call, IDDSI'?‑‑‑Yes.

PN1077

'Some of the changes in the care plan include' � then you talk about those things. I sent you a document earlier, which is that � do you see that?‑‑‑I've got that here somewhere, yes.

PN1078

It might be easier to find this one; it's okay?‑‑‑Yes, I've got - - -

PN1079

This is the International Dysphagia Diet Standardisation Initiative?‑‑‑That's right.

PN1080

So when you talk about IDDSI, this is what we're talking about it, is it?‑‑‑I think it's called IDDSI.

PN1081

I wish somebody told me that before today. That would have helped me. Bear with me. I've also sent you a heavily redacted, marked‑out care plan. Do you have that document as well?‑‑‑Yes.

PN1082

I'm not going to take you through this care plan in any detail, other than to ask you to go to the bottom of page 3?‑‑‑The pages are stuck together.

PN1083

I'm sorry about that?‑‑‑That's okay. Yes. Yes, the bottom of page 3, I've got that.

PN1084

MR WARD: I just want to make sure I understand how this all works. This is a care plan. Obviously I'm not going to name whose it is or where it's from. It says, 'My recommended food consistency, IDDSI 7 regular; my recommended fluid consistency, IDDSI 0 thin.' Do you see that?‑‑‑Yes.

PN1085

I'll just start with this question. When a resident comes into Edgecliff, where they sit on the IDDSI scale, is that in their care plan?‑‑‑Yes, and they give me their dietary requirements � are sent to me. I have a folder with all that. The copy's kept actually in the kitchen so you can refer to that continually.

PN1086

So if you're cooking that pork meal, you'll know whether or not you've got to make 28 regulars or three minced and moist; you'll understand that?‑‑‑Yes.

***�� MARK CASTIEAU�� XXN MR WARD

PN1087

If you could go back to the IDDSI scale again, I'm just trying to understand this. It says, 'Regular.' I take it that just means you serve it as I would eat it?‑‑‑Yes. As for aged care, it's always a bit softer than normal.

PN1088

Okay, a little bit softer?‑‑‑A little bit softer � it's softer than you get in a restaurant.

PN1089

No, thank you, that's very helpful. And then, 'Easy to chew', is that you still have to cut it up; is that - - -?‑‑‑'Easy to chew' is a little bit � 'Regular' is just like anything; 'Easy to chew' is a bit softer.

PN1090

Is 'Soft and bite‑sized', does that mean you cut it up?‑‑‑Yes, it's cut up to a bite size, like two centimetres square or three centimetres square.

PN1091

And you'd do that with a knife or - - -?‑‑‑Yes, we'd do that with a knife.

PN1092

Then you've got, 'Minced and moist'?‑‑‑Yes.

PN1093

Do you use a mincer for that?‑‑‑you could use a food processor, or you could actually with a sharp knife � the chef can mince with a knife, if it's only a small amount.

PN1094

And then, 'Puree.' I take it you use - - -?‑‑‑Use a food processor.

PN1095

And then just help me out, what does 'Liquidised' mean?‑‑‑That's like pureed with extra water, it'll have a lot of fluid in it.

PN1096

Okay?‑‑‑You'd use stock or milk, or something nutritious.

PN1097

When you're serving that pork meal, all of the residents who want the pork meal could have the pork meal. How it's actually presented to them might relate to the IDDSI?‑‑‑That's correct.

PN1098

Can I take you to paragraph 63?‑‑‑Yes.

PN1099

My apologies, sir � 61, sorry, sir?‑‑‑Yes, I've got that.

***�� MARK CASTIEAU�� XXN MR WARD

PN1100

As the kitchen is closed between 6.30 and 7, I make sure I leave sandwiches and salads in the kitchen area in case someone gets hungry in the middle of the night. I clearly label these so that the residents are not accidentally given something that would make them sick.

PN1101

When you say you label them, is that you mark some as gluten free; is that what you're talking about?‑‑‑Yes, gluten free and its IDDSI requirements.

PN1102

So it might be this is an IDDSI 6 or an IDDSI 5?‑‑‑Yes. But I'd write 'soft and bite‑sized.' I wouldn't put the number, because the overnight staff wouldn't understand what the number meant. 'Minced and moist', like � we have special stickers for that. We put stickers on that have all that. If it's for IDDSI that you can put on, and it says exactly what it is.

PN1103

Are they different colours?‑‑‑Yes.

PN1104

So there will be a sticker that says, 'Minced and moist'?‑‑‑Yes. That'd be brown, like that.

PN1105

So the colours on that chart are what the stickers would be?‑‑‑Yes.

PN1106

Thank you, that's very helpful?‑‑‑And if you run out of stickers I just write it on something else.

PN1107

Can I just take you back to paragraph 44 where you're talking about serving lunch?‑‑‑Yes.

PN1108

And this might apply to dinner as well. Once you've prepared the food, is it maintained in a servery?‑‑‑Yes, it's put in a bain‑marie.

PN1109

So that will maintain the temperature of the meat, the vegetables, as you're serving up?‑‑‑It will maintain the meat, and we check � we keep checking that it doesn't fall below 60 degrees.

PN1110

Yes?‑‑‑If it falls below 60 degrees you have to reheat it or discard it.

PN1111

Is that a rule just for you, or is that a rule that applies in restaurants generally?‑‑‑That's for food service across the board.

***�� MARK CASTIEAU�� XXN MR WARD

PN1112

Okay?‑‑‑Below 60 � in between 5 degrees and 60 degrees, that's when bacteria can grow. That's the danger zone.

PN1113

I'll remember that next time my steak's cold?‑‑‑Yes.

PN1114

Can I take you to paragraph 90?‑‑‑Yes.

PN1115

I think I'm right in saying this � it says you've been provided with 'specialist training on how to deal with dementia residents.' Do you see that?‑‑‑Yes.

PN1116

Was that training online? How was training delivered?‑‑‑Some of it's online, but I have had educators come to the facility and do that.

PN1117

Yes?‑‑‑But mostly online now, these days.

PN1118

Are you required to do that every year or every two years or - - -?‑‑‑It's regularly. It comes up on your education folder on AutumCare. It'll come up, you have to do this, you have to do that, and you have to do it. There's a lot of online courses now. Before we used to have educators come to the facility, but now they're mostly online.

PN1119

And the online course for dementia, how long does that take you to do?‑‑‑It would probably take half an hour or an hour.

PN1120

Is that an assessment as well?‑‑‑Yes. It'd probably take an hour. It would take an hour.

PN1121

Is the assessment multiple choice?‑‑‑Yes. You have to move around things with the mouse and put things in different spots and all that sort of stuff.

PN1122

What do you mean by 'things', sir?‑‑‑I forgot how you do it. You move � you lift something with the mouse and you move it to another, to where it's supposed to go, and you move your answer - I've forgotten what it's called. You drag - you drag it across.

PN1123

You drop and drag the answer?‑‑‑Yes, yes.

***�� MARK CASTIEAU�� XXN MR WARD

PN1124

Okay?‑‑‑It's like a multiple choice thing. You have to put everything in the right order.

PN1125

I understand, I understand. Can I take you to the second statement. Do you have that in front of you?‑‑‑Yes.

PN1126

Can I take you to the very end to begin with, paragraph 29. Can you go there?‑‑‑Yes, wait a sec. Yes.

PN1127

It says:

PN1128

At the Edgecliff facility, kitchenhands were employed as care service employees under the enterprise agreement, so they were expected to interact with residents every day.

PN1129

?‑‑‑Yes.

PN1130

So, can you just - can you just - - -?‑‑‑Well, they're called CSEs, they're called CSE, whatever grade they are, but everyone there's expected to interact with the residents. They're constantly interacting with the residents, everyone is.

PN1131

You don't allow the residents into the kitchen itself, do you?‑‑‑No. No.

PN1132

So, the interactions you have would be walking around the dining room?‑‑‑Yes, they might - - -

PN1133

Walking through the facility, those sorts of things?‑‑‑They come up to the servery and look into the kitchen and ask for help or ask for something. The servery faces the dining room, residents can come up and ask for something from them.

PN1134

And for the ones who aren't ambulant, would you take the meal out to them?‑‑‑Yes. No, people come up to the servery, if they have an inquiry they'll come up to the servery and ask.

PN1135

If they want to know what's for desert, they'll come and ask you?‑‑‑Whatever, yes. Or they're going out or they want me to do something special for them or whatever, or they're having a guest, all sorts of things. Sometimes they just want to come up and have a chat.

***�� MARK CASTIEAU�� XXN MR WARD

PN1136

And you're comfortable chatting?‑‑‑I love it, yes. That's one of the best things about the job. Lovely.

PN1137

You talk in paragraph 28 about kitchenhands?‑‑‑Yes.

PN1138

I think you say they work the breakfast shift as described above. Do they kitchenhands ordinarily prepare breakfast?

PN1139

---Yes.

PN1140

And you don't do that?‑‑‑No, no.

PN1141

What do they do for breakfast?‑‑‑They cook - they cook porridge, a hot meal; sausages, eggs, porridge, there's always porridge, pancakes they'll serve. They'll also serve like a continental breakfast; cereals, toast, croissants, that sort of thing.

PN1142

And who trained them to do that?‑‑‑Me.

PN1143

Okay, you've trained them to do that?‑‑‑Yes.

PN1144

Am I right in saying they don't actually bake the bread?‑‑‑No.

PN1145

They're not doing - they're not actually baking pastry or anything like that?‑‑‑No, they might reheat some frozen pastries maybe.

PN1146

Right. Can I take you to paragraph 28. Could you have a look at that for me?‑‑‑Yes.

PN1147

If you can go to (h)?‑‑‑Yes.

PN1148

It says:

PN1149

Serve meals to residents in the dining room.

PN1150

Do you see that?‑‑‑Yes.

***�� MARK CASTIEAU�� XXN MR WARD

PN1151

It's not a trick question. I'm just trying to understand, when you say 'serve residents in the dining room', that would involve putting the meal out in front of them?‑‑‑That's right.

PN1152

It wouldn't involve you feeding them?‑‑‑No, not usually. Sometimes a kitchenhand is also a carer.

PN1153

Right?‑‑‑And they have experience, they might feed them if they know how to do that properly, if they're trained to do so.

PN1154

I see?‑‑‑That's rare. If someone needs feeding it's a carer will do that do.

PN1155

Carer would do that?‑‑‑Yes.

PN1156

So, sometimes you do actually have kitchenhands who are also qualified carers do you?‑‑‑Occasionally.

PN1157

That's fine. You see (j), you say:

PN1158

Supervise residents in the dining room.

PN1159

?‑‑‑Yes.

PN1160

What do you mean by 'supervise'?‑‑‑Well, look after them.

PN1161

So, there's no carers around when they're eating?‑‑‑There is but there may not be. If they're busy elsewhere there won't be.

PN1162

Okay. So, if something - if, for instance, if a resident starts to choke or something like that, you press the alarm to get a carer?‑‑‑That's right.

PN1163

I've just got a couple more questions then I've finished, Mr Castieau, thank you. Who do you actually report into?‑‑‑The facility manager.

PN1164

Directly in to the facility manager?‑‑‑Yes. That's my boss.

***�� MARK CASTIEAU�� XXN MR WARD

PN1165

That's your boss, yes. I was going to use that phrase but I didn't know if it was the right phrase?‑‑‑Yes.

PN1166

I'm not suggesting you're not good at your job but has there ever been a formal complaint about the food where you work?‑‑‑There would have been. Someone would have written a letter and made a complaint, occasionally that happens.

PN1167

Okay, and who do they normally write to? Do they normally write to your boss or - - -?‑‑‑Yes.

PN1168

Okay. And I take it your boss then comes and talks to you about the complaint?‑‑‑We have a meeting and we sort it out.

PN1169

Okay?‑‑‑We have a meeting with whoever made the complaint. It's very rare but it has happened.

PN1170

I'm just interested, how long did it take you to be confident in the job?‑‑‑Not long, no. I started at a different facility. I was sent there by an agency and I really enjoyed it and then they offered me a permanent job, so I took it.

PN1171

So, you were sort of fully functional after what, a year or - - -?‑‑‑A few months.

PN1172

A few months, just a few months?‑‑‑Yes.

PN1173

Okay, that's fine?‑‑‑But it's - no, maybe it took a longer time. I've been doing it for 20 years so I can't really remember.

PN1174

That's all right, no?‑‑‑You learn - you're always learning and you get - you get better and better at it as you go.

PN1175

Thank you, Mr Castieau, thank you. No further questions?‑‑‑I'll just say when I first started, I was supervised by a catering manager who would show me the ropes, how do it.

PN1176

Okay, so that person sort of helped you out when you started?‑‑‑Yes.

PN1177

And I presume you now help out with people who work for you?‑‑‑Yes.

***�� MARK CASTIEAU�� XXN MR WARD

PN1178

Thank you very much. No further questions?‑‑‑You're welcome. Thank you.

PN1179

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

RE-EXAMINATION BY MR GIBIAN�� [10.15 AM]

PN1180

MR GIBIAN: Yes, just a few matters. Mr Castieau, can you hear me?‑‑‑Yes.

PN1181

Firstly, you were asked some questions about paragraph 5 of your first statement and the qualifications and certificates that you list in that paragraph?‑‑‑Yes.

PN1182

I think the Certificate III which is at (a) was clear enough. The second, the Certificate in Food Handling and Food Safety, I understood you said in answer to questions that Mr Ward asked you that you did that every year?‑‑‑We do that every year, an external educator comes in and does a couple of hours education and there's also modules online to do as well.

PN1183

And that's an annual thing every day, that is - - -?‑‑‑Yes.

PN1184

Right, I understand. Then (c) is a reference to Certificate in Food Safety Supervising, and you were asked some questions about that as well?‑‑‑Yes.

PN1185

When did you do that certificate?‑‑‑Well, I did it probably about three years ago.

PN1186

Was that a one off rather than the recurrent thing, such as the - - -?‑‑‑That was the first time I did it because it wasn't required before, but now it is.

PN1187

And is that - are you required to do that annually or renew it?‑‑‑Every five years.

PN1188

Five years. Okay, thank you. So, you've done it once so far but in a couple of years you'd have to do it again if you're still doing that work?‑‑‑Yes.

PN1189

I understand?‑‑‑There was somebody else at the facility, one of the managers had done it, so someone in the facility has to have done it - - -

PN1190

Yes, I understand?‑‑‑ - - - before one of the managers did it to, I don't know, maybe take the load off me a bit.

***�� MARK CASTIEAU�� RXN MR GIBIAN

PN1191

You were then asked some questions by reference to paragraph 30 of your first statement, particularly the manner in which the national menu is set?‑‑‑Yes.

PN1192

In answer to those or to a question, you indicated that you had to follow the national menu but you would alter depending on the residents' needs?‑‑‑Yes, likes and dislikes and needs.

PN1193

I just was going to ask you if there are any examples of the types of alterations or amendments that you would make and the reasons why that would be done?‑‑‑Well, maybe something is too spicy, they didn't like it, or not spicy enough or maybe one of the meals, one of the recipes, they just didn't like so you do something else.

PN1194

Then you were asked some questions about paragraph 44, particularly the first sentence, where you'd indicated in the paragraph that on an ordinary day you would make one main meal for lunch and one main meal for dinner. In answer to that question you said that had changed since this statement was prepared?‑‑‑Yes.

PN1195

There was, as I understood it, two alternatives each day?‑‑‑Yes.

PN1196

When did that change?‑‑‑That changed - would have been last August. I moved to Bronte after that and different chefs came in and did that.

PN1197

All right, and that might answer the next question I was going to ask. To your knowledge was that a change across St Vincent's Care institutions or specific to Edgecliff?‑‑‑Some facilities had done that for a long time but because our facility was small, it wasn't done. They re-organised the staffing in the kitchen so that would happen and then I moved to Bronte, changed where I work because it's very close to my house (indistinct) the same street, so I moved there.

PN1198

All right, I understand - and what was the situation at Bronte? Was that one meal or two meals?‑‑‑When I was there it was one - plus an alternative. You always do an alternative, maybe like half a dozen alternatives in case someone changed their mind but now they do two separate meals in the bain marie.

PN1199

Plus alternatives?‑‑‑If someone needs it, yes.

PN1200

I understand. You were then asked some questions about the IDDSI framework - 'Iddsi', I think you referred to it as?‑‑‑Yes.

***�� MARK CASTIEAU�� RXN MR GIBIAN

PN1201

I just have one question about and that was that you referred at paragraph 61 of the first statement to placing out meals in the evening, I think, or sandwiches and salads in the kitchen area in case someone is hungry at night and that those are labelled?‑‑‑Yes.

PN1202

Are those labels for the staff or for the residents?‑‑‑The staff.

PN1203

Yes. Then you were asked then some questions by reference to paragraph 44 of your first statement about the serving of the meals in the bain marie and the monitoring of the temperatures. You indicated that food had to be discarded if it went below 60 degrees?‑‑‑It has to be reheated.

PN1204

Reheated, I'm sorry?‑‑‑But if it's below 60 degrees for more than two hours then it has to be discarded. If it's below 60 degrees then the length of time that it's been below 69 degrees you have to take off the two hours, if you understand.

PN1205

All right. You describe that as an across-the-board requirement?‑‑‑Yes.

PN1206

Are you able to tell us what the source of that requirement is - that is, is it a particular regulation or requirement?‑‑‑It's Food Standards Australia regulations - Food Standards Australia and New Zealand. It's also Food Standards New South Wales, for vulnerable people.

PN1207

The last matter I was just going to clarify was you were asked about the dementia care training that you did?‑‑‑Yes.

PN1208

I think it's referred to in paragraph 90 of your first statement and in answer to that question you indicated that it came up in your education folder on what you referred to as AutumCare?‑‑‑It would say, yes, AutumCare if they had dementia, yes.

PN1209

I understood your answer to be that AutumCare - which is a software system, as I understand it, is that correct?‑‑‑That's right - (indistinct) how you communicate, everything is on AutumCare, everything in the facility.

PN1210

Does AutumCare maintain a record of the training that you have done and need to do and remind you of that requirement?‑‑‑I don't know if AutumCare does that but someone takes care of that and we're always told if your training is due. Yes, that comes up on another software called Workplace.

***�� MARK CASTIEAU�� RXN MR GIBIAN

PN1211

All right, I understand. Yes, those were the matters that I wanted to clarify, Mr Castieau. Thank you very much for coming to give evidence, unless the Commissioner has any questions, of course.

PN1212

COMMISSIONER O'NEILL: No, thank you, Mr Castieau, for your evidence today. You're now excused and can leave?‑‑‑Thank you very much.

<THE WITNESS WITHDREW�� [10.23 AM]

PN1213

MR GIBIAN: Commissioner, as I understand, with the next witness who is Mr Jones, he is actually physically going to go and sit in the seat that Mr Castieau is in at the moment.

PN1214

COMMISSIONER O'NEILL: All right. It looks like Mr McKenna might have something he wants to say.

PN1215

MR GIBIAN: Sorry.

PN1216

COMMISSIONER O'NEILL: You can go, Mr Castieau, but thank you again.

PN1217

MR McKENNA: Commissioner, I just note that Mr Castieau was taken to some witnesses - - -

PN1218

COMMISSIONER O'NEILL: Sorry, did you have some questions? I'm sorry.

PN1219

MR McKENNA: No, no, I don't. I was just going to raise an issue with regard to documents but I'm just told that it's been resolved so I'll sit back down.

PN1220

COMMISSIONER O'NEILL: Okay.

PN1221

MR McKENNA: Thank you, Commissioner.

***�� MARK CASTIEAU�� RXN MR GIBIAN

PN1222

MR GIBIAN: I was actually going to raise the same issue. Well, maybe an issue in relation to documents - it could perhaps be useful and I don't know whether it might be most useful if it's done as we go along, if Mr Ward is cross-examining by reference to particular documents that there be some indication as to whether or not he is seeking to have those as part of the evidentiary record. I'm not sure whether you, Commissioner, want to mark them in some way. I think the president referred to them the other day being included in the court book. But I'm not sure that necessarily is going to be each of the documents we've been sent on all occasions. It might have been in this case.

PN1223

I don't think Mr Ward went back to the enterprise agreement with Mr Castieau so I'm not sure whether that would be part of the documentation but perhaps it should be just made clear at the conclusion of each witness's evidence if possible which of those documents is proposed to be part of the evidentiary record.

PN1224

COMMISSIONER O'NEILL: That seems to be a sensible approach, Mr Ward.

PN1225

MR WARD: It's a reasonable question. I had assumed from the comments from the President the other day that to the extent that I took the witness to anything they would - we were required to formally tender them, that they would be accepted. I'm not particularly perturbed about the enterprise agreement. It's a statutory instrument of a matter of public record. I didn't take the witness to it. We might refer to it later on though.

PN1226

COMMISSIONER O'NEILL: It just might be helpful if when at the conclusion of witness evidence or as you go through if you refer to which document in the digital hearing book it is.

PN1227

MR WARD: That's fine. Can I just indicate then, that to use old language, I seek to rely on the Certificate III Commercial Cookery, the IDSII Diet Standardisation Initiative Schematic and the care plan, which we showed the witness.

PN1228

COMMISSIONER O'NEILL: I understand that but if future witnesses see those you can just identify when you're presenting information to them which document in the digital hearing book it is so that everyone - - -

PN1229

MR WARD: They're not in the hearing book, Commissioner.

PN1230

COMMISSIONER O'NEILL: Okay. All right. And if they are not - so you are seeking to rely on those?

PN1231

MR WARD: And for them to form part of the hearing.

PN1232

COMMISSIONER O'NEILL: All right. Can you just give me those again.

PN1233

MR WARD: It's the Australian Government SIT30816, Certificate III in Commercial Cookery.

PN1234

COMMISSIONER O'NEILL: Yes.

PN1235

MR WARD: The single pay schematic which sets out the (indistinct) framework, and the redacted My Care Plan.

PN1236

COMMISSIONER O'NEILL: Okay. Unless there's any objection to that I will arrange for those to be added to the digital hearing book. All right, are you ready for your next witness, Mr Gibian?

PN1237

MR GIBIAN: I believe so. Yes, that was a useful process. That is I have a few documents on email at the moment, so that is useful just to know on each occasion what is in fact being sought to be evidence, and we can object if we need be, but I don't think (indistinct). I think Mr Jones should be - I'm getting a thumbs up at the back of the room, but not on the screen at the moment. Someone is running.

PN1238

COMMISSIONER O'NEILL: Good morning, Mr Jones. Commissioner O'Neill here, can you hear me all right?

PN1239

MR JONES: I can hear you, yes.

PN1240

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

PN1241

THE ASSOCIATE: Mr Jones, can you please state your full name and work address?

PN1242

MR JONES: Paul Reginald Jones - - -

PN1243

COMMISSIONER O'NEILL: Excuse me, Mr Ward, sorry. Mr Jones, it was just difficult to hear you for a moment there.

PN1244

MR JONES: Paul Reginald Jones, Richmond Lodge, 67 Barker Street, Casino, New South Wales.

<PAUL REGINALD JONES, AFFIRMED�� [10.29 AM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [10.29 AM]

***�� PAUL REGINALD JONES�� XN MR GIBIAN

PN1245

COMMISSIONER O'NEILL: All right, Mr Jones. Mr Gibian?

PN1246

MR GIBIAN: Yes, thank you, Mr Jones. I think you know I'm Mark Gibian, I appear for the HSU. Can you just repeat your full name for the record?‑‑‑Paul Reginald Jones.

PN1247

And you're a care services employee United Protestant Association in Casino?‑‑‑Correct.

PN1248

And you've made two statements for the purposes of the proceedings. Do you have those with you?‑‑‑I do, yes.

PN1249

The first of those is dated 1 April 2021 and runs to 54 paragraphs over 11 pages. Do you have a copy of that statement with you?‑‑‑Yes.

PN1250

And you've had an opportunity to read through it again?‑‑‑I have, yes.

PN1251

And is it true and correct to the best of your knowledge and recollection?‑‑‑It is, yes.

PN1252

Commissioner, that's at document 189 commencing at page 10,892 and we seek to rely upon that statement. Mr Jones, there was then a further witness statement which was made dated 20 April of this year, 2022, running to - it doesn't have page numbers, but 27 paragraphs. Do you have a copy of that one as well?‑‑‑Yes.

PN1253

And you've also had an opportunity to read through that statement and is it true and correct to the best of your knowledge and recollection?‑‑‑Yes.

PN1254

That's document 190 in the digital court book commencing at page 10,903, and we also seek to rely upon that statement in the same manner. Mr Jones, you will be able to see one of the windows has Mr Ward in it. He will now ask you some questions.

PN1255

COMMISSIONER O'NEILL: Mr Ward, you're on mute.

CROSS-EXAMINATION BY MR WARD�� [10.31 AM]

PN1256

MR WARD: I doubt you could have answered, Mr Jones, good morning, can you hear me?‑‑‑I can hear you now. Good morning.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1257

Thank you, Mr Jones, good morning. My name is Nigel Ward, Mr Jones, and I appear in these proceedings for the employer interest, and if I could ask you a few questions, sir. You started life as a truck driver, did you?‑‑‑Well, various jobs of that nature; logistics work, warehousing, truck driving, but predominantly driving trucks, yes.

PN1258

Your decision to move into aged care what drove that?‑‑‑I wanted a change and I wanted to do something where I thought I was making a difference in people's lives, and, you know, driving a truck everybody relies on things being delivered, but you're not really making a difference, you know, because if you don't deliver it somebody else will. So, yes, I just wanted - wanted a change.

PN1259

Do you find the work rewarding?‑‑‑Very much so, yes.

PN1260

Who do you actually report into in your operation, who's your boss?‑‑‑The care manager.

PN1261

And is the care manager a registered nurse?‑‑‑I'm not sure. My understanding was that the rules have changed and so that the care manager had to be a registered nurse, but, yes, I couldn't say for sure. We do have a registered nurse who is the clinical lead. Yes, I couldn't say for sure whether - - -

PN1262

That's fine, sir. Don't try and answer a question if you're not comfortable answering it. So you have a registered nurse in the facility though?‑‑‑Yes, during the day between - yes.

PN1263

You say in your statement at paragraph 9 - do you have that in front of you?‑‑‑The first statement?

PN1264

Yes, sir?‑‑‑Yes.

PN1265

You say you've got a Certificate III in aged care and disability care. Were you required to have that to work for UPA?‑‑‑I was, but I had done that course before I applied to work for UPA. I did the course and then went looking for a job in aged care.

PN1266

Okay. I take it that course had both the theory component and a practical component?‑‑‑Yes.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1267

Do you recall if your practical component was 120 hours?‑‑‑I believe it was, yes.

PN1268

And where did you do your practical?‑‑‑I did my prac at a Southern Cross facility called St Michael's, which is also in Casino.

PN1269

Is that an aged care facility as well?‑‑‑It is, yes.

PN1270

Can I take you to paragraph 12 of your statement. Paragraph 12 starts with the words, 'When a resident is first admitted.' Do you see that?‑‑‑I do see that, yes.

PN1271

I just want to see if my understanding is yours, sir, about a few things. Am I right that when a resident is admitted the registered nurse has met with the resident and the family and designed a care plan?‑‑‑Yes, they have at that stage begun the basic care plan I guess you could say, but that is filled out over time as we learn more about the resident.

PN1272

But to the extent that the resident has a care plan that's completed by the registered nurse at the point of admission, is it?‑‑‑Yes.

PN1273

Okay. That's fine. Now, when you're on shift do you normally work with - I think you said you work with a small number of residents. Do you normally work with the same residents?‑‑‑Generally. We have 18 residents in the west wing. I do the majority of my shifts on that wing. And we have 12 residents in the dementia unit and I do two shifts a fortnight in the dementia unit.

PN1274

Can I ask you to leave the dementia unit for later, I will come back to that, I will. When you're on the west wing do you normally have the same people to look after when you're on the west wing?‑‑‑Sorry, you dropped out there, the same what?

PN1275

That's okay. Do you normally have the same residents to look after when you're on the west wing?‑‑‑Yes. We do have one respite room, so we might have that room being changed more regularly, like different residents coming through, but for the other 17 rooms, yes.

PN1276

Are you responsible for caring for all 17 or do you care for a number of them?‑‑‑All 18, including the person that's in respite.

PN1277

When you're on shift, is anybody on shift with you?‑‑‑If we are fully staffed I'll have two other care staff working with me on that afternoon shift.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1278

Are they at the same level as you or are you more senior to them?‑‑‑Some are, some are the same level as me. Some do not have their medication competencies. They'd all have at least a Certificate III though.

PN1279

Okay. Just keep your mind at the west wing if you could. When you're with a resident, I assume that you enter information about the resident on their chat?‑‑‑Not on their chart. We have a documentation system called WeCare that we use.

PN1280

Is that an iPad system or - - -?‑‑‑We use laptops at the nurses station.

PN1281

Okay. So, just help us out if you can. If a resident - if you've toileted a resident, do you enter that on the system?‑‑‑Yes.

PN1282

And if you've showered a resident, do you enter that on the system?‑‑‑Yes.

PN1283

Okay. And if you observe something unusual about the resident, a mood change or whatever, do you enter that?‑‑‑Yes, we do progress notes.

PN1284

Progress notes?‑‑‑Yes.

PN1285

Would you do that at the end of the shift?‑‑‑You do it as you get an opportunity. Like, when I'm doing the medication rounds I'll just make notes in a notepad and do documentation after I've completed the rounds, so yes, but it varies.

PN1286

The progress notes get entered onto this system, do they?‑‑‑They do, yes.

PN1287

Okay. And who reviews the progress notes? Does the RN review the progress notes?‑‑‑The RN and the care manager.

PN1288

Okay. And is the care manager that person who's your boss?‑‑‑Yes.

PN1289

So, if they review those notes and believe the care plan should be changed, do they then get you involved to talk about they're thinking of doing?‑‑‑Not in that sense, no. they rely upon our documentation to make the changes.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1290

And having made a change to the care plan, would the RN tell you it's been made or would the care manager?‑‑‑It would generally be put out as an alert through the WeCare system. We have a messaging system (indistinct).

PN1291

You would pick up that message and you would understand that something's changed?‑‑‑Yes.

PN1292

Thank you very much. Now, you also said a moment ago you work in the dementia ward. Is that right?‑‑‑Yes.

PN1293

Is that a secure unit?‑‑‑Yes.

PN1294

And I take it those people have been assessed as needing to stay in a secure unit?‑‑‑The majority of them, yes. We do have one resident who is in there by choice but yes, the other residents are all there assessed as a risk of wandering and, yes.

PN1295

So, the residents in the dementia ward, they could be - they could be ambulant, they might not be ambulant but there's a risk of them wandering and that's why they're secure?‑‑‑Yes.

PN1296

I'm just interested. When you did your Certificate III, what prepared you in your Certificate III for working with people with dementia?‑‑‑There was a lot of reference - my trainer who put me through the course was a former aged care worker herself so she gave us quite a few examples but there were units in the training that dealt with dementia, the different types of behaviours that can, you know, be associated with dementia.

PN1297

Did that include how to identify those behaviours and how to de-escalate situations?‑‑‑Yes.

PN1298

Now, can I just come to paragraph 19. It says - paragraph 19 starts:

PN1299

In order to be able to administer medications, I was required to complete an online course.

PN1300

Do you see that?‑‑‑Yes.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1301

It's not a trick question, I'm just trying to understand what that means. Do you know what the online course was called?‑‑‑I can't recall off the top of my head but it was a course that my employer required me to do, like it wasn't something I could go and select myself.

PN1302

No, that's okay, that's okay. Do you recall whether or not it was a unit of competency from a Certificate III or Certificate IV?‑‑‑It may have been. Yes, it's a couple of years since I did that now so - - -

PN1303

That's all right. Did you do it online?‑‑‑Yes.

PN1304

And how long - how many hours did you do online?‑‑‑I can't recall the total number of hours.

PN1305

That's fine. If you can't recall, you can't recall. Did you do an assessment?‑‑‑Yes, I was assessed by the RN.

PN1306

Was it in - the course, was the course run in-house by your employer?‑‑‑Well, we would - the time spent doing it was in-house, during the work time on the work computer. Yes, it was - because I had been - they like everybody, all staff to have their medication competencies once they've been there for a little time, so.

PN1307

That's okay. And how long ago is it that you did it?‑‑‑Well, it was over 12 months ago because I was - I was doing medications when I made my first statement. I'd probably been there maybe a year before I started on my med comp, so yes, three to four years.

PN1308

Can I just, if I can, I'd like to understand the medication process, so just stay with me as I try and walk through this. I take it that the registered nurse gets the medications out and puts them on a medication trolley. Is that right?‑‑‑No, the person doing the medication round, in my case myself, has a set of keys which includes a key to the medication cupboard. It doesn't include a key to the safe in which the S8s are stored but yes, I'm responsible to get the Webster-paks from the medication cupboard, put them on the trolley and go and commence the medication round.

PN1309

That's fine. So, you've just said the Schedule 8s are in a safe. Is that right?‑‑‑Yes, that's correct.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1310

That's right. So, you're dealing with what we call Schedule 4 medications?‑‑‑Yes, however there are in some cases we have one resident who has Endone as a part of their regular medications and that is packed in their Webster-pak which is not kept in the safe. PRN Endone would be kept in the safe but their regular medications are not.

PN1311

No, that's fine. I'll come back to it if I can. So, you've got a key to the Schedule 4 cupboard?‑‑‑Yes.

PN1312

You open that cupboard up and is it - are the Webster-paks set out by resident?‑‑‑Yes, each resident has their own Webster-paks - - -

PN1313

And are the - - -?‑‑‑And we have a couple of racks with - we have them in alphabetical order on the racks.

PN1314

Are the Webster-paks weekly packs or monthly packs. What are the Webster-paks?‑‑‑Weekly.

PN1315

Weekly. So, you'll take the pack out and it'll have Monday's, Tuesday's, Wednesday's pills in it?‑‑‑Correct.

PN1316

And what type of pills might it have in there?‑‑‑Panadol Osteo, various (indistinct), like bowel medications. There's some medications that I'm not sure what they actually do with names like Axit, Eliquis, Lyzon - Lyzalon, I forget the pronunciation on that one.

PN1317

You put them on the trolley?‑‑‑Put those Webster-pak racks on the trolley, yes.

PN1318

And you would then start effectively your medication round. Is that right?‑‑‑Yes.

PN1319

When you get to - let's just say you get to the first resident, how do you check that what's in the Webster-pak is correct?‑‑‑We have a triple check regime. We check the chart, what - the names of the medications in the Webster-pak, printed on the Webster-pak itself.

PN1320

Yes?‑‑‑Where we check that against what's on the chart, and then we have an electronic sign‑off system called MedSig, computer program, and that also lists what medications a resident would have in a particular round. We can't just rely on that though because that would be the last thing to be updated. If there are any changes, the first place the change is going to appear is on the chart when the doctor makes a change. So the chart is the Bible basically.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1321

So there's three checks?‑‑‑Yes.

PN1322

Do the checks also include you checking the actual appearance of the tablet against the picture?‑‑‑Yes.

PN1323

So you check the name and you check the appearance of the tablet against the picture that says this is what it should look like?‑‑‑Yes.

PN1324

Do you do that at the nurses station before you start your rounds, or do you do that resident‑by‑resident?‑‑‑You do that resident‑by‑resident.

PN1325

You're the only person checking those pills?‑‑‑At that stage, yes. I believe Webster‑paks are supposed to be checked by the RN when they are delivered to the facility by the pharmacy, but then, yes, we'd � the care staff need to check again as we're administering.

PN1326

Could I ask you to go to paragraph 25 of your statement - - -

PN1327

COMMISSIONER O'NEILL: Before you do, Mr Jones, can I just ask you, what does PRN standard for?‑‑‑It is a Latin phrase that I have forgotten, but it means 'as required.'

PN1328

Okay?‑‑‑So generally PRN medications are for pain relief or appearance(?), like for bowel medications, but yes, the Latin phrase translates as 'as required.'

PN1329

Thank you.

PN1330

MR WARD: Could I take you to paragraph 25?‑‑‑Yes.

PN1331

See the last sentence there, it says this: 'How medications are to be administered is also marked on each resident's Webster‑pak', do you see that?‑‑‑I do. That relates to whether they need to be crushed or not. If a medication is to be crushed, that will be marked on the Webster‑pak.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1332

So after you've done your triple check, you'll read the instructions as to how it's to be administered. If it's to be crushed, how would that be actually given to the resident?‑‑‑We crush medications, we put them either in a fruit puree or custard, just some medium that is easy for them to swallow. If they have pureed food as part of their meal, which most residents who have crushed medications do, we might just put it in a little bit of their meal, a bit of mashed potato, for example, and give it to them, if we give them the medication as they are having their dinner.

PN1333

I take it that you observe them taking it, do you?‑‑‑Yes.

PN1334

And then you have to record somewhere that they've taken it?‑‑‑Yes. That's recorded on the MedSig program.

PN1335

And that's the thing you talked about before?‑‑‑Yes. It's a separate computer system to leave care, and it's actually � the information that is put on there is put on by the pharmacists. So pharmacists have been known to make mistakes, both in the Webster‑paks and in MedSig, and that's why the chart is the Bible.

PN1336

If a medication's added that you've never seen before, do they update the picture charts?‑‑‑Eventually, yes. It doesn't always happen as immediately as it should.

PN1337

But would that be a change to somebody's care plan you'd be informed of?‑‑‑Well, a change in medication would just be a change in their medication chart, not in the care plan itself.

PN1338

So their medication chart sits separately to the care plan?‑‑‑Yes, the medication chart sits in a folder that lives on the medication trolley so it's easily accessible if a GP comes to visit the resident or the RN needs it for some other reason.

PN1339

You talked a minute ago about schedule 8 drugs?‑‑‑Mm‑hm.

PN1340

Like morphiates and things like that. The registered nurse does those?‑‑‑If it's a PRN schedule 8 drug, then yes, it can only be administered by an RN. However, I repeat if it's � Endone is an s8, but some residents have it as a regular medication, and in that case they are packed in their Webster‑paks and care staff administer it with a witness from a second medication company care staff member, because it has to be double‑signed on the MedSig program.

PN1341

So for your normal schedule 4 was you don't need double sign‑off?‑‑‑No.

PN1342

But if somebody has put an Endone inside a Webster‑pak, you would need double sign‑off?‑‑‑Yes.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1343

I take it that's the only time you can be involved in schedule 8 drugs?‑‑‑In terms of actually administering them, yes.

PN1344

Yes?‑‑‑I also administer insulin, but - - -

PN1345

I'll come to that. Does the registered nurse do the schedule 8 round by themselves?‑‑‑Well, there's no round per se. Most of the schedule 8 medications are PRN medications, so yes, they do that as required basically.

PN1346

Am I right in saying that a PRN medication could also include Panadol?‑‑‑Yes.

PN1347

Do you have authority to issue a PRN?‑‑‑I have to call the � if a resident requests a Panadol, first of all I'll check on MedSig to see how long since they've had the previous one, because, you know, you've got to have so many hours in between. If it's been enough time that they could have it, I would then call the RN to get approval to give it.

PN1348

Okay?‑‑‑Including the on‑call RN, if it's after the RN (indistinct) - - -

PN1349

After hours. At paragraph 28 you talk about administering insulin. That's right? It is 28, yes?‑‑‑Yes.

PN1350

In terms of that, the administration of insulin, I take it that's injected?‑‑‑Yes.

PN1351

Just give me a moment. Am I right in saying you use an insulin medication dose aid?‑‑‑The pens are a dosage aid in that you can set the amount of units to be injected with the pen itself, where you dial it to the right number of units that you need to inject.

PN1352

But how will you know what the units are?‑‑‑You take the resident's blood glucose or blood sugar level. We have one resident at the moment who has two types of insulin. He has a long acting one that he always has the same amount each time. Then he has another where the amount given is on a sliding scale, depending on what his blood glucose level is. So we may give him 10 units, 12 units or 14 units, depending on where he is with his blood sugar.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1353

Is the process for insulin similar to your schedule 4 process, or is there a different process?‑‑‑Well, it's more similar to the schedule 8 in that it has to be double‑signed. If there is an RN in the building, the RN should administer the insulin and I will simply be the witness. However, we have a resident who has insulin in the bedtime round at about 8 o'clock at night and the RN is not there by that time, so I administer it and a second care staff, who also has insulin competency, will witness it.

PN1354

Just to my knowledge, what was the training package you did to do that?‑‑‑It was online and then basically just watching � like, being taught by the RN, being shown on the job; on the job training basically.

PN1355

Do you recall how many hours online it was?‑‑‑It wouldn't have been much, maybe an hour.

PN1356

I'll just quickly take you to paragraph 30. I'll move through a few things reasonably quickly. You talk in paragraph 30 about using heat packs to manage the resident's pain?‑‑‑Yes.

PN1357

I take it that's something you learnt in your Certificate III?‑‑‑Yes.

PN1358

In 31 you talk about feeding residents, learning to put food on a spoon?‑‑‑I didn't have to learn to put food on a spoon. Me mother taught me about 50 years ago, 54 years ago - but yes, each resident will have a preferred way for having their medication and their food so yes, this paragraph is more about dinner than the medications.

PN1359

It's about providing food, I think - it's about feeding people?‑‑‑Yes, yes, well, there are some residents that need to be spoon-fed and there are others that can feed themselves but require close supervision because of their dysphagia, difficulty in swallowing.

PN1360

You would have learnt about dysphagia when you did your Cert III?‑‑‑That's correct.

PN1361

Yes. I'll take you to paragraph 49. I'm not trying to be rude to you, Mr Jones, when I say this: you say here, 'When performing my role I am not rarely supervised'. Am I right in saying what you really mean by that is you are not directly supervised?‑‑‑Yes, correct.

PN1362

Yes, but you're indirectly supervised doing certain things by the registered nurse or your boss, aren't you?‑‑‑Yes.

PN1363

Yes?‑‑‑So they're not on the floor with me.

***�� PAUL REGINALD JONES�� XXN MR WARD

PN1364

No, they're not watching you as you do whatever you're going to do?‑‑‑No, that's correct.

PN1365

Okay. Can you go to your second statement? I'm almost finished, sir. Could you go to paragraph 24? You talk here about dealing with families?‑‑‑Yes.

PN1366

I'm right in saying that understanding how to communicate with residents and families is part of your Certificate III training?‑‑‑Yes.

PN1367

Again, I'm not trying to offend you, but if there is a formal complaint made against you, would that go to your boss or somebody else?‑‑‑Presumably it would go to the care manager, I suppose. If the complaint was from a family member they might go via the RN or they might go direct to the care manager. It would be a matter for them.

PN1368

But you could be in a room with a resident when their son comes in and their son could raise a question about the health of their parent and you would be the recipient of that, wouldn't you?‑‑‑The recipient of the question?

PN1369

The question, yes?‑‑‑Yes (indistinct).

PN1370

Sorry - if it got heated with that person, who would you escalate it to?‑‑‑Probably the RN and the care manager, yes.

PN1371

Thank you, Mr Jones - thank you very much, Commissioner, no further questions.

PN1372

COMMISSIONER O'NEILL: Thank you. Mr Gibian, anything in re-examination?

PN1373

MR GIBIAN: Yes, just a few matters.

RE-EXAMINATION BY MR GIBIAN�� [11.01 AM]

PN1374

MR GIBIAN: Mr Jones, can you hear me again?‑‑‑Yes.

***�� PAUL REGINALD JONES�� RXN MR GIBIAN

PN1375

First of all, you were asked some questions about who you report to and I think you indicated you report to the care manager but that there was also an RN who you described as the clinical lead, who is present during the day. What are the hours of the RNs present?‑‑‑8 am till 7 pm there is an RN there. The clinical lead often isn't there until 7 pm, though. She'd be there sort of business hours, yes. There is no RN on duty after 7 pm.

PN1376

I understand. I think you referred to there being - was it on call or RN in the evenings, is that right?‑‑‑That's correct - whichever RN has been on duty on a given day, becomes the on call RN that evening because they are the most up to date with where the residents are at. So you can't just pick the closest RN and call them. You have to call the one that is on call and as I say in my statement, three of them live at least half an hour away.

PN1377

Now, you were then asked some questions about the care plans and you described there as being a basic care plan filled out at a time that a resident is admitted but that it's filled out over time?‑‑‑Yes, it develops - it's a living document so it's evolving all the time.

PN1378

What is the method by which it's filled out over time?‑‑‑Well, basically, it's a product of the documentation of care staff as changes in the resident will become apparent through the documentation and through progress notes and that's what influences changes to the care plan.

PN1379

You were then asked some questions about how many other carers are working at the same time as yourself and you said that when you were fully staffed there would be two others on the afternoon shift?‑‑‑On that wing, on the west wing, yes.

PN1380

On the west wing, sorry - two others in the west wing on the afternoon shift?‑‑‑Yes.

PN1381

How often are you or are you usually fully staffed or how often does it occur where you're not fully staffed?‑‑‑More often than it should but yes, especially at the moment with so many staff either off with COVID or through being a close contact, staffing is a massive issue at the moment. I had to - I was rostered to work an afternoon shift last night but I had to take that off so I could travel down here to do this. I was told by the care manager - she was happy for me to do it but she said that they just literally could not replace me. They had no one else that they could call in so that was a shift that would have been short-staffed last night.

PN1382

I mean, I'm sure it varies depending upon events, as you say but is that something that happens sort of once a week, or once a month or - - -?‑‑‑More likely to be once a week than once a month, yes.

***�� PAUL REGINALD JONES�� RXN MR GIBIAN

PN1383

You were then asked some questions about the documentation system and the progress notes that you complete on the documentation system. I'm not sure this was common to others but I just missed the name of the documentation system that you mentioned. What was the name of it?‑‑‑Leecare.

PN1384

Leecare - and you were asked about the medication course that you did, which I think the questions were asked by reference to paragraph 19 of the first statement, I think, and you were asked how many hours the course was and you said you couldn't recall, I think, which is understandable enough. I just wanted to ask, can you provide any kind of indication - that is was it a course that went for a week or for weeks or how long did the course go on for?‑‑‑It was the kind of course you could do at any time. It was - yes, there are a certain number of units and each unit was about half an hour to an hour in length. Yes, you didn't have to do it over a set period. If you had the time to do all your units within a week you could do it that way. Yes, I can't recall exactly how many units there were.

PN1385

I understand. You were then taken through the process of doing your medication rounds. I think the end of that process is you were asked about - you were asked whether you observed the resident taking the medication?‑‑‑Yes, I have to be sure that they have safely swallowed any medication that they (indistinct).

PN1386

Yes, I just want to ask you whether you have residents who firstly have difficulty taking the medication?‑‑‑We do have some, yes.

PN1387

What are examples of the difficulties and what do you have to do to try and ensure the medication is taken appropriately in those instances?‑‑‑For some residents it involves crushing the medication and putting it into some pureed food or just through puree, and just giving them very small amounts of the puree at a time. Other residents in the dementia unit it might involve re-approaching, because you will give them the medication, they will take it in their mouth, then just work it around in their mouth for five minutes and spit it out. So if you can catch it and try again, you know, that's what you do. So you might have to revisit a particular resident four or five times during the course of the medication round just to get them to take all of their medication, and ultimately sometimes they don't. You know, if they've spat it out onto the floor you've got to dispose of it and you just sign it off as having been refused by the resident.

PN1388

I was going to ask you separately, but maybe you've covered it already whether there are residents who are resistant to taking medication and what types of techniques or the like that you employ in that event?‑‑‑Yes, that - my last answer was - I was thinking of (indistinct) medication resistant resident (indistinct).

***�� PAUL REGINALD JONES�� RXN MR GIBIAN

PN1389

All right. You were then asked - and the last thing was you were asked some questions about insulin injections, and I think you described how you did that in the evening, and you described the processes taking the blood glucose and then administering the insulin. How is the blood glucose level checked?‑‑‑We have - we have little - I couldn't tell you the name of them - little prickings I guess that prick the skin of the resident. We then have a machine on which you put a droplet of blood onto a stick that is inserted into the machine and the machine will give you a digital readout of what the blood glucose level is. So it's during the day when the RN is on duty. I will do the blood glucose and have everything prepared ready for the RN to come and do the injection.

PN1390

And how does the blood glucose reading inform the insulin to be administered?‑‑‑Well, with the resident who is on the sliding scale if his BGL is below a certain level, which it's on his chart and (indistinct) at the moment, then he gets 10 units of insulin, but if it's - if it's a bit higher than that - I think if it's below - if his BGL was below 10 he would get 10 units, and if it was 10 to 15 he would get 12 units; 15 to 20 he gets 14 units, and that sliding scale is developed by the resident's doctor.

PN1391

Thank you. Those were the additional matters I just wanted to clarify. Thank you, Mr Jones.

PN1392

COMMISSIONER O'NEILL: All right. Now, I'm sure that by the 80th witness I have the resident routine down pat, but, Mr McKenna, I should have given you the opportunity. Did you have any questions for Mr Jones? You're on mute, sorry.

PN1393

MR McKENNA: No, thank you, Commissioner.

PN1394

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

PN1395

Thank you.

<THE WITNESS WITHDREW�� [11.11 AM]

PN1396

COMMISSIONER O'NEILL: All right. It's 11.10, I suggest that we just take a short break at this moment before the next witness, so we will resume at 11.20.

PN1397

COUNSEL: Thank you, Commissioner.

***�� PAUL REGINALD JONES�� RXN MR GIBIAN

PN1398

COMMISSIONER O'NEILL: The Commission is now adjourned.

SHORT ADJOURNMENT�� [11.11 AM]

RESUMED�� [11.20 AM]

PN1399

COMMISSIONER O'NEILL: Mr Gibian, is Ms Ellis ready?

PN1400

MR GIBIAN: I understand so.

PN1401

COMMISSIONER O'NEILL: Good morning, Ms Ellis. Commissioner O'Neill here. Can you hear me all right?

PN1402

MS ELLIS: I can.

PN1403

COMMISSIONER O'NEILL: All right. So, my Associate's just going to have you take the affirmation.

PN1404

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

PN1405

MS ELLIS: Virginia Ellis and I work for Uniting Aged Care facility, 381 Great Western Highway, Springwood.

<VIRGINIA ELLIS, AFFIRMED�� [11.21 AM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [11.21 AM]

PN1406

COMMISSIONER O'NEILL: Mr Gibian.

PN1407

MR GIBIAN: Thank you, Commissioner. Ms Ellis, can you hear me?‑‑‑Yes.

PN1408

You're just a bit quiet, at least from my end so I'm not sure whether you can shuffle slightly closer to the computer or something?‑‑‑Is that better?

PN1409

Yes, I can hear you at least. All right, thank you. Can you repeat your full name for the record?‑‑‑Virginia Ellis.

***�� VIRGINIA ELLIS�� XN MR GIBIAN

PN1410

And you're employed as a homemaker at the Uniting Aged Care facility in Springwood, in New South Wales?‑‑‑Correct.

PN1411

You're one of the individual applicants in the proceedings, I think?‑‑‑(Indistinct reply)

PN1412

You've made two statements for the purposes of the proceedings. Do you have copies of those with you?‑‑‑I do.

PN1413

The first of those is dated the - I think it's 25 March 2021, and runs to 27 pages across 237 paragraphs. Do you have a copy of that one?‑‑‑I do.

PN1414

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

PN1415

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

PN1416

That, Commissioner, is document 139 within the digital court book, commencing at page 10004. And we seek to rely upon that statement and have it as part of the evidentiary record. Ms Ellis, you also made a statement headed statement - 'Reply witness statement', sorry, 'of Virginia Ellis', dated 20 April of this year, 2022, running to 81 paragraphs. Do you have a copy of that also?‑‑‑I do.

PN1417

And you've had an opportunity to read that and is it also true and correct to the best of your knowledge and recollection?‑‑‑It is.

PN1418

That, Commissioner, is document 140, commencing at page 10039 and we also seek to rely upon that statement.

PN1419

COMMISSIONER O'NEILL: Yes.

PN1420

MR GIBIAN: Ms Ellis, Mr Ward who you should see in one of the boxes on the screen will now ask you some questions.

CROSS-EXAMINATION BY MR WARD�� [11.24 AM]

PN1421

MR WARD: Ms Ellis, can you hear me?‑‑‑I can.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1422

My name's Nigel Ward, Ms Ellis. I appear in these proceedings for the employer interest. Thank you for coming today. Can I - do you have your statements in front of you? Could I start with your first statement?‑‑‑Yes.

PN1423

Can I ask you to go to paragraph 25. I just want to make sure I understand your qualifications?‑‑‑Sure.

PN1424

You say:

PN1425

I completed a Certificate III in Aged Care 16 years ago.

PN1426

Unless my maths is really bad, I think that takes us to about 2006. Is that roughly right?‑‑‑Approximately, somewhere - - -

PN1427

Somewhere round that, okay, that's fine. And then you've got your Certificate IV in Aged Care in 2011?‑‑‑Yes.

PN1428

And your Leisure - Lifestyle and Leisure Certificate IV in 2014, and I'm right, aren't I, that later on in your statement you say you've done a Certificate III in Commercial Cookery?‑‑‑I did that, yes, I have completed that.

PN1429

Yes, and did - have you completed that?‑‑‑Yes.

PN1430

What year did you complete that?‑‑‑That would have been probably about 14 years ago.

PN1431

So, around 2008?‑‑‑Would have been, yes.

PN1432

Around that, okay?‑‑‑Yes.

PN1433

When you did your first Certificate III in Aged Care, did you do that because you were looking to work in the aged care sector and were required to?‑‑‑No, I wasn't required to. It was something that I wanted to do.

PN1434

Wanted to do, okay?‑‑‑Yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1435

Does the same apply to your Certificate IV in Aged Care?‑‑‑Correct. Yes, I wanted to do it, yes. I wanted to upgrade my skills and that.

PN1436

And the same for your Lifestyle and Leisure Certificate IV?‑‑‑Yes.

PN1437

I take it that your Commercial Cookery Certificate III, that that was again something you just wanted to do?‑‑‑That's something that I wanted to do, yes.

PN1438

I think you say in your statement that you were employed by Buckland Aged Care Services between 2005 and 2009. That's correct, isn't it?‑‑‑Yes, I'm not sure of the exact dates but yes, I worked at Buckland's, yes.

PN1439

Am I right that Buckland's is different to Uniting?‑‑‑It's an aged care facility, they're both aged care facilities.

PN1440

But they're not owned by the same people?‑‑‑No.

PN1441

No, okay. And where - geographically, where was the Buckland facility?‑‑‑It's at Springwood.

PN1442

Springwood. And you leave Buckland in 2009 and you start working for Uniting. Is that right?‑‑‑Correct, yes.

PN1443

Can I take you to paragraph 31?‑‑‑Yes.

PN1444

You're talking in paragraph 31 about a dementia ward. Am I right in saying that's at Buckland?‑‑‑No, that's at Uniting.

PN1445

That's at Uniting?‑‑‑Yes.

PN1446

You have not given us any evidence about what happened at Buckland? It's not a trick question, I'm just trying to understand. This evidence is about your employment at Uniting?‑‑‑Yes.

PN1447

Yes. Okay, that's fine. Can you go to paragraph 32, you say:

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1448

I don't remember having any dementia specific training before I started in the ward.

PN1449

Is it your recollection that you did no training in your Certificate III related to dementia?‑‑‑Not that I recall, no.

PN1450

And you did no training in your Certificate IV related to dementia?‑‑‑I don't recall, but I'd worked with dementia a lot before doing my Cert IV, so I had gained a lot of experience.

PN1451

You don't recall whether or not dementia was part of the course program for a Certificate III or a Certificate IV?‑‑‑I don't believe it was in Certificate III, but I mean it's a long time ago.

PN1452

Okay. You set out in paragraph 34 what your day was like, and it goes from (a) to (p), do you see that?‑‑‑Yes.

PN1453

Is there anything between (a) and (p) that was outside of your Certificate III training?

PN1454

MR GIBIAN: I mean I object to that question. I'm not sure that it's fair to ask a question in such a rolled up way about a course that was done 16 years ago.

PN1455

MR WARD: If the witness can't answer it she can say so.

PN1456

THE WITNESS: Can I just read it?

PN1457

MR WARD: Yes.

PN1458

MR GIBIAN: I maintain the objection that it's not a fair matter of asking that question to the witness.

PN1459

COMMISSIONER O'NEILL: If the witness isn't able to answer it given the amount of time and how long ago it was then she can answer in that way, but if she does recall then she can answer, or she may - I will stop there.

PN1460

MR GIBIAN: May it please.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1461

MR WARD: Commissioner, I will try and deal with it in a different way to assist if I can and try and be fair. I take it in your Certificate III you were trained in how to personally care for a resident?‑‑‑Correct.

PN1462

By way of an example can I ask you to go to (d)?‑‑‑Yes.

PN1463

I am right, aren't I, that in your Certificate III you would have been trained both in the classroom and also in your practical about bathing, dressing and skin integrity?‑‑‑Definitely bathing and dressing. I don't recall about the skin integrity or excoriations or bruising, but - - -

PN1464

So it could have been part of it, but you don't recall?‑‑‑I don't recall, you know - no, I don't recall any kind of tuition on that. I mean it would be common sense if you see somebody hurt that you would - or if you see somebody with something that doesn't look right that you should report it.

PN1465

How many hours practical did you do for your Certificate III, Ms Ellis?‑‑‑I think it was something like 100 hours, 120 hours.

PN1466

And in the 100 hours practical you did for your Certificate III were you ever exposed to skin integrity issues?‑‑‑I couldn't remember that far back.

PN1467

Okay. You can't remember, that's fine. Can I take you to paragraph 43, please. You start paragraph 43 by saying, 'As a team leader.' How many people are in your team?‑‑‑Are we talking about, I think the dementia ward here, there would be three, three and myself.

PN1468

So you're responsible for three people?‑‑‑Correct.

PN1469

Are they all Certificate III qualified as well?‑‑‑Yes. As far as we know, yes.

PN1470

You don't know if they are?‑‑‑Well, I'm not sure what everybody's qualification is, no.

PN1471

Okay. That's fine if you don't know. I am just going to read 43 out if I can.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1472

I would do dressings and administer medications. The RN would do the schedule 8 round with me. After that the RN wasn't present as she was so busy looking after other residents and this fell to me.

PN1473

Are you saying there that you would start a schedule 8 round of medications. The RN would be called away and you completed the schedule 8 round by yourself?‑‑‑No, I'm not saying that. I mean it has happened. It's not ideal, but it has happened if somebody - something serious has happened.

PN1474

So you have administered schedule 8 medications yourself, have you?‑‑‑The RN may have given the tablet, but maybe the person hasn't quite swallowed it and they've had to shoot off and I've just remained to make sure that it hasn't been spat out or something.

PN1475

But you haven't administered schedule 8 medications?‑‑‑It's not up to me to administer them, it is up to the RN to administer them.

PN1476

If you go to paragraph 53 you say:

PN1477

I had to learn how to build a good relationship with the residents' family members. I received lots of calls and text messages from people asking lots of questions.

PN1478

Do you recall whether or not in your Certificate III you were taught anything about communicating with family members?‑‑‑I can't recall.

PN1479

You can't recall?‑‑‑Yes.

PN1480

Am I right in saying that you provided your private phone number to the family members?‑‑‑Well, not - I personally haven't always given my phone number out. When I worked as the bus driver before I became a homemaker, I worked as lifestyle and leisure, and lifestyle and leisure you developed a different relationship with the residents and family members, and quite often they would get your phone number because you dropped them off at the shopping centre and you would wait with the residents that weren't able to move around by themselves and they would have your number, 'I'm ready, could you come and help me', and so on and so on.

PN1481

So when you were acting as the team leader - - -?‑‑‑Yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1482

- - - do you normally hand out your private phone number to family members?‑‑‑No, not always, no, not at all.

PN1483

Not always or not?‑‑‑Look, some people have got them because they're really - they're really concerned about their loved one and they just - they just want to be able to contact somebody that has good English and knows their parent, knows them well.

PN1484

So you do hand out your private phone number?‑‑‑I have a couple of times. I had two ladies that - one lived in America and one lived in Italy and it was mainly for WhatsApp. So we did it through WhatsApp, because I would do a Zoom chat with both daughters once a week, because their - - -

PN1485

Does your employer Uniting approve of you handing out your phone number?‑‑‑No, this - the numbers were given out quite some time ago, like I said when I was the bus driver, and - yes. And so I don't make it as a practice, but they still have my number. So every now and again, yes, I get messages, and I'm afraid to say we have to use our phones, our personal phones at work for messaging, phone calls, different things like that.

PN1486

Now, you then at paragraph 60 start talking about homemaker, do you see that?‑‑‑Yes.

PN1487

I think you say at paragraph 62, 'I have a team of four employees.' That's different to a moment ago when you said you had three. When you said you had three, was that talking about something else?‑‑‑That was � I think I'm referring to the dementia ward there. Now I'm a homemaker.

PN1488

Homemaker?‑‑‑Yes.

PN1489

So there's you and a team of four in the homemaker set up?‑‑‑When I made this statement I was homemaker in a section called Wattle. So I would have two of a morning and myself, and then two of an afternoon and myself, and then there would be one night shift, which I have never engaged with.

PN1490

So you were responsible for four people, but they weren't always rostered on at the same time?‑‑‑Yes. That's correct.

PN1491

Can I ask you to go to paragraph 62?‑‑‑Yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1492

You say there:

PN1493

So I have a team of four employees that report to me. The homemaker role has a lot more responsibility than that of a CSE -

PN1494

I'm just going to pause there. I assume you're talking about a CSE in a traditional residential setting?‑‑‑Yes, I think sometimes you refer to them as PCWs.

PN1495

Yes?‑‑‑Assistant in nursing, yes. (Indistinct), yes.

PN1496

as I have ultimate responsibility for the care of the residents.

PN1497

Do you see you say that?‑‑‑Yes.

PN1498

So when you're a homemaker, the registered nurse doesn't have responsibility for them?‑‑‑For the staff?

PN1499

No, for the residents. You say here you have ultimate responsibility for the care - - -?‑‑‑For my � okay. For my household, my boss would be the RN, and then it would be the deputy director and then the manager. So the buck would stop � I would go to my RN first if I had a problem that I couldn't solve, we needed help with, or a wound, I would go to her.

PN1500

Right?‑‑‑And try to get (indistinct).

PN1501

So the RN would have ultimate responsibility for those things?‑‑‑Yes.

PN1502

And you wouldn't?‑‑‑Well, no. That would be her decision to call.

PN1503

Do you have a clinical care manager in your operation?‑‑‑You mean at the whole of the facility?

PN1504

Yes?‑‑‑That would be � our clinical care manager would be our manager.

PN1505

Do the registered nurses report to that person?‑‑‑I think they go to � they would go to her, they would go to the deputy � deputy manager.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1506

Who is your boss now you're in homemaker?‑‑‑Well, at the end of the day it would be the RN, would be my first port of call.

PN1507

So you report to the registered nurse, do you?‑‑‑I do. I go to the manager as well.

PN1508

When you say you 'go to the manager', what do you go to the manager for?‑‑‑If we have � like, I went to her last week because our annunciators aren't working, we have no Dect phones, and the RNs are fully aware of this, but it's very hard to do the job, to answer the call buttons within a 10‑minute break when you haven't got anything to tell you that people are buzzing.

PN1509

You went to the manager because that isn't the responsibility of the registered nurse?‑‑‑It is, but nothing's happening.

PN1510

Okay, so you were dissatisfied with how you were - - -?‑‑‑So I just escalated it, because we needed to get it done, yes.

PN1511

Sorry, I must have missed this. In your home, how many residents do you have?‑‑‑Well, I've now moved upstairs, so - - -

PN1512

When you gave your evidence how many residents did you have?‑‑‑Twenty‑three downstairs.

PN1513

So you and your team of four are responsible for 23 residents?‑‑‑Over the whole day.

PN1514

Yes?‑‑‑So of a morning it's myself and two people.

PN1515

Yes?‑‑‑Of an afternoon shift it's myself and two people. Overnight it's one person.

PN1516

You say you've moved 'upstairs'?‑‑‑Yes. There's 35 residents up there. There's myself and three people, but two of those people are only on till 1 o'clock, and then it's myself and one other person until 3 o'clock, and then one more person comes on � or two more people upstairs.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1517

When you gave your evidence � sorry, just remind me again, Ms Ellis, what was the place called that you looked after?‑‑‑In the first statement, downstairs was Wattle.

PN1518

Wattle?‑‑‑Yes, and upstairs where I work now is Magnolia.

PN1519

When you worked at Wattle, are all the residents high needs residents?‑‑‑I think all but maybe three of them, who don't have care.

PN1520

So Wattle's not set up as a specialist dementia area. It just happens that a lot of them have advanced dementia?‑‑‑It was � you know, like back in the day, it was meant to be a low care hostel. Now it is a high care nursing home really. We have people with dementia, we have bed‑bound people, we have a lot of by twos. We have just everything.

PN1521

Can I take you to paragraph 66?‑‑‑I can't hear anybody.

PN1522

COMMISSIONER O'NEILL: That's all right. I don't think Mr Ward's asked anything just at this moment?‑‑‑I thought he - - -

PN1523

MR WARD: Ms Ellis, I apologise. I think Mr Ward's leant on his computer. My apologies. I'll have to not do that again. At paragraph 66, you see the heading, 'Medication rounds'?‑‑‑Yes.

PN1524

I just want to walk through this to make sure I understand what you're saying. This is while you're in Wattle, is it, this evidence?‑‑‑Yes.

PN1525

Yes, okay. 'I start work at 8 am' � this is a):

PN1526

I start work at 8 am and go in and check a communication book where the RN and CSE who has been on the night shift will have listed any issues that came up the night before or matters that need attending to.

PN1527

?‑‑‑Yes.

PN1528

I take it that that is how the night shift handover to you - what's happened on the night shift, is it?‑‑‑Yes, I don't technically get a handover anymore, being a homemaker.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1529

You don't get a verbal handover?‑‑‑No.

PN1530

So you're required to read the book to find out what's been going on during the night‑time, is that right?‑‑‑Correct, and I'm relying on staff to have had the time to write in that book.

PN1531

Yes, I understand that, but that's the process that your company has put in place?‑‑‑Yes.

PN1532

Yes?‑‑‑I don't know if it's been something that's put in place. It's just � that's just the way it's just panned out. You know, staff are busy, staff are, you know, under the pump, and it's just happened. They don't have that 10 minutes to spend and hand over to that 6.30 staff that come on.

PN1533

So the night shift, I take it that they would enter progress notes?‑‑‑Yes.

PN1534

Are those progress notes on paper or are those progress notes in the system?‑‑‑They're on a computer.

PN1535

And you'd have access to that when you start at 8 am?‑‑‑Yes, I would have if I - I don't have the time to go to the computer access it. That's why I normally go and find the RN and let her know I'm here, anything out of the ordinary that I need to know.

PN1536

So because you're so busy you don't read the progress notes?‑‑‑Not on the computer, no, I don't.

PN1537

But you just said you go and find the RN; you go and do that, do you?‑‑‑I normally ring her.

PN1538

Okay, you ring her?‑‑‑While I'm getting the food trolley from downstairs loaded up with stuff, I will be ringing her and saying, look, I'm here, is there anything I need to know; I'll meet you upstairs and we'll do the S8s.

PN1539

When you ring her up and say is there anything I should know, I take it that's your handover?‑‑‑Yes, she'll tell me if somebody's gone to hospital, somebody's come back from hospital, somebody's COVID‑positive, somebody's had a fall, somebody's going out, you know. Maybe if I was on the day before she might say, you know, there's nil changes from yesterday, and so on.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1540

That's the handover process you use?‑‑‑Mm.

PN1541

Yes?‑‑‑Well, that's what working at the moment. We are � well we were before COVID meant to be having two huddles a day, one in the morning with day shift and one in the afternoon with the afternoon shift. Just with COVID and being short-staffed and just under - just run off our feet, they have not been happening. But we're trying to start to implement them again and we're getting one an afternoon at the moment.

PN1542

So your evidence is that you understand what happened at night, not by reading the progress notes but by ringing the RN?‑‑‑By talking directly to the RN.

PN1543

Directly to the RN, and she tells you what you need to know as you start your day?‑‑‑Yes.

PN1544

If you go to what I think is 66B: 'I try and start the schedule 8 medication around the DRN about 8.15 or 8.30'?‑‑‑Yes.

PN1545

Then just letting you read on, the sentence finishes: 'Or let them know when I can assist so I can get the schedule 8 medication round'. Then C says: 'The schedule 8 medication round is the medication round where S8 drugs are administered. This could include morphine, oxycodone, fentanyl. The administration of S8 drugs needs to be witnessed by two people to ensure that the correct medication and the correct dosage is administered'?‑‑‑Yes.

PN1546

Just stay with me for a minute. I just want to be fair to you. Then you see D: 'The schedule 8 medication round usually goes for about half an hour'. You explain what it consists of and then you get to (iv): 'Administering the schedule 9 medication: the RN will always administer insulin, morphine and opiates and patches. Half the time the RN makes me sign the relevant forms and then I run the other S8 drugs'. Do you see the, 'then I run the' - - -?‑‑‑Yes.

PN1547

You're not saying there that you administer schedule 8 drugs, are you?‑‑‑No.

PN1548

No?‑‑‑I administer them with the RN in charge.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1549

So you're allowed to administer schedule 8 drugs, are you?‑‑‑Well, sometimes some residents - the ones with dementia - if it's an unfamiliar RN or an agency RN and they just won't take anything off them because they don't know them, the RN sometimes says, 'Can you give it to them', and I just stand back. That has happened.

PN1550

Okay, so you on occasions will administer schedule 8 drugs?‑‑‑Yes, well, in those circumstances, yes.

PN1551

When you say you have to sing off on them, I take it that is the RN showing you what they're going to give the resident and you confirming that you think that's correct?‑‑‑Well, when you're getting the S8s out you have to do a count. We have to write out a book and we have to do a count.

PN1552

Who is 'we'?‑‑‑The RN and myself - so we both sign this book to say that there was 20, we're talking one, that leaves 19, do we agree with that? If it's the end of the page then we have to go to a clear page and also sign that book, sign from that page to say that we've brought it forward. So it's quite time-consuming when you have a lot of S8 drugs.

PN1553

If you can go to 66E, you say: 'Whilst doing this round I will check the blood pressure and blood sugar levels of residents and record this on their chart'?‑‑‑Yes.

PN1554

I assume that was all part of your Certificate III training?‑‑‑Maybe more Certificate IV, I would think. I'm not sure that's Certificate III.

PN1555

So you don't recall it being in your Certificate III training?‑‑‑Doing blood pressure and BSLs? No.

PN1556

No, okay - do you recall it being in your Certificate IV training?‑‑‑I think mores in the Certificate IV. I'm not sure though. That's a long time ago, yes.

PN1557

Okay, that's fine?‑‑‑Yes.

PN1558

When you say you record this on their chart, that's the chart that is part of the progress notes, is it?‑‑‑Well, under their file on the computer they will have their chart there so I just have to go and pull their chart up, their BSL chart, their behaviour chart - whatever chart it is - and then enter the details in there.

PN1559

Okay?‑‑‑So when the doctor comes or they go to hospital, we can just print all those charts out and it's there.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1560

That's fine?‑‑‑I do a paper copy of that as I go. Then before the end of my shift then I add everything in to the charts.

PN1561

At 67 you talk about schedule 4 medications?‑‑‑Yes.

PN1562

Can I just see - I'm just trying to see if your way of doing schedule 4 is different to anybody else's. Just bear with me. I assume that the schedule 4 medications are kept under lock and key?‑‑‑Yes.

PN1563

Do you have the key?‑‑‑No.

PN1564

Does the RN have the key?‑‑‑Yes.

PN1565

So in terms of the schedule 4 medications, they're kept in a cupboard. The RN unlocks the cupboard to take them out and when she takes them out, are they already in Webster-paks?‑‑‑They are.

PN1566

She would then put them, what, on the trolley?‑‑‑Yes, she would just hand me, 'There's your S4s'.

PN1567

You would then start your rounds, is that right?‑‑‑Correct.

PN1568

The Webster-paks, are they weekly paks or are they monthly? What are they?‑‑‑Seven days.

PN1569

Seven days, so you will know that there's four pills for Monday, when you get to Mr Smith?‑‑‑Yes.

PN1570

Am I right in saying that when you get to Mr Smith - hopefully there isn't a Mr Smith, that would be embarrassing - when you get to that person you have to verify that those pills are the right pills. You have to do that?‑‑‑Correct.

PN1571

Am I right in saying that you have to check off the name of the pills - is that correct?‑‑‑Yes.

PN1572

Then do you have like a picture chart to make sure that the pill looks like the pill it's meant to be?‑‑‑There's actually a picture chart on their EMS - on the Webster-pak.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1573

Right?‑‑‑Some people's Webster-paks don't run Monday to Sunday. Some of them are packed upside down and back to front because some people don't use the one pharmacy. So you have to be quite vigilant and make sure that you're giving breakfast - because all our blister packs that come from our one chemist are all breakfast across to dinner but some pharmacies pack them back to front.

PN1574

So if you have my seven-day pack, it could be Monday breakfast, Monday lunch, Monday dinner?‑‑‑Yes.

PN1575

There has been some other evidence by another person this morning that said that written on the Webster-pak is how they're to be administered?‑‑‑Correct.

PN1576

That's the same for you, is it?‑‑‑Yes. Well, normally our blister packs, they'll have maybe two tablets in each little blister. So breakfast will go right across. Some people have a couple of rows, some people only have one and so you know, you take from the top rows all for that day, if that's what you mean.

PN1577

Okay?‑‑‑Down the bottom it'll tell you the name of the drug, whether it can be crushed, whether it can't be crushed.

PN1578

If you're giving Mr Smith his medication, is it written on Mr Smith's Webster-pak that it should be crushed?‑‑‑I think it'll say on the Webster-pak you can't crush but on the EMS, when you bring Mr Smith up, it'll have Mr Smith's requirements: he needs his pills crushed and served with custard or Gloup, which is a medication lubricant, or one at a time, so on and so on.

PN1579

Yes. So you follow how you're told to administer it with Mr Smith?‑‑‑Yes.

PN1580

Am I right in saying that you have observe that the medication has been taken?‑‑‑Yes.

PN1581

You then record that the medication has been taken?‑‑‑Yes, I will tick each one. I make sure that if Mr Smith is due 10 tablets, Mr Smith gets 10 tablets. Sometimes there might only be eight tablets. They might be out of stock. They might be a short term, so in fact he's got 12 tablets because he's on antibiotics and so I have to check all those things and make sure everything's taken.

PN1582

Yes?‑‑‑Then I'll tick, 'administered' of if they're refused - - -

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1583

You tick 'refused'?‑‑‑Well, first off I will try a couple of different approaches, over maybe half an hour.

PN1584

Yes?‑‑‑If he still refuses, then I will dispose of them, tick 'refused', document and report it to the RN in charge.

PN1585

Yes, and if you are checking a Webster-pak for Mr Smith, and a tablet doesn't look right, who do you contact?‑‑‑I will ring the RN.

PN1586

You don't ring the pharmacist, you go straight to the RN?‑‑‑No, I go to the RN.

PN1587

Okay. I take it it's the RN's responsibility then to work out what to do?‑‑‑Correct.

PN1588

Thank you very much?‑‑‑If there's a - if there's a - like last weekend there was a whole weekend of tablets missing, nobody had organised them so I rang the pharmacy and got a stat dose so that the resident had her tablets for the weekend.

PN1589

I might have missed this so help me out if I've missed it. Did you do a separate course to be allowed to administer Schedule 4 drugs?‑‑‑We - every six months with Uniting they do a medication competency with us and they just go through everything. We do - - -

PN1590

Is that an in-house course run by Uniting?‑‑‑I think so, yes. They have - - -

PN1591

Okay, (indistinct) - - -?‑‑‑Yes, they have one of their trainers, because they do a lot of online courses. They have their trainer come out or it's be an RN that will be assigned to you to do your medication competencies, and that's every six weeks - every six months. We're given a booklet with questions we have to answer, give back and then participate - - -

PN1592

So it's not an online course, it's face to face with the RN, is it?‑‑‑They come and do a medication round with us.

PN1593

And are you sitting in the classroom with the RN?‑‑‑No, no, she will say Virginia we're going to do your competencies today with lunch time meds, okay.

PN1594

So, she'll do it on the run as you're actually delivering the meds?‑‑‑Yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1595

So, it's - she observes you actually doing it and says you're okay?‑‑‑Yes.

PN1596

Okay?‑‑‑And she'll watch me, you know, administer eye drops, puffers, creams, whatever.

PN1597

Yes. Schedule 4 obviously is more than just tablets, isn't it?‑‑‑Yes, there's different creams, yes.

PN1598

Can I take you to paragraph 88. This is all about your homemaker model?‑‑‑Mm-hm.

PN1599

Paragraph 88 starts with this:

PN1600

The home is meant to provide six meals a day. We share the kitchen with the catering company.

PN1601

See that? I'm just trying to understand the role of the catering company. So, I take it the facility has a central kitchen?‑‑‑Yes, that's off our dining room.

PN1602

Yes, so it has a central kitchen, a big kitchen?‑‑‑Yes.

PN1603

And am I right in saying that in your home room, you have a kitchen as well?‑‑‑That main kitchen that does all the cooking for all the different buildings is our kitchen. They have a little stainless steel bench outside where they set up hotplates and they put their food on that to keep warm for the dinner service (indistinct).

PN1604

Okay, so just bear with me. It was called Wattle wasn't it?‑‑‑Yes.

PN1605

So, Wattle doesn't have its own kitchen?‑‑‑No, not - no, it has a communal kitchen with the big kitchen.

PN1606

So, just bear with me?‑‑‑Yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1607

Because I might be thinking of something that you're not thinking about. We've seen a homemaker model where there was a kitchen actually in the homemaker unit that had what looked like a residential kitchen sitting in it?‑‑‑Wattle does not have that. If you want to call what they have there a kitchen, by all means. There's a sink and there's a stainless steel bench but no resident can do any cooking there because it's taken over by the kitchen staff all the time. And if we do do activities there, you know, 11 o'clock, we need the kitchen, you have to move, you have to move or - - -

PN1608

That's okay, that's okay. So, there's a - - -?‑‑‑Upstairs in Magnolia, there is more of a kitchen setup with an oven and hotplates and things like that.

PN1609

That's okay. And is that - is the Magnolia kitchen separate to the central kitchen or is that the central kitchen?‑‑‑No, no, it's just upstairs. It's just a little kitchenette upstairs.

PN1610

Right, it's a kitchenette. And when you say it's a kitchenette, does it have an oven in it?‑‑‑It has an oven and it has two hotplates, yes. A fridge.

PN1611

And again that's separate to your central kitchen?‑‑‑Correct, yes.

PN1612

Okay, that's good, that's fine. And you say in your evidence that - sorry, I withdraw that. Does the central kitchen prepare breakfast?‑‑‑They cook - so, they're set up - that's the kitchen there, just outside in that little kitchenette thing they've got off the kitchen, they put hotplates. They put stainless steel tubs of porridge and a kitchen staff member is meant to serve anybody that comes down to the dining room for breakfast. Okay. We, when I come in, I've got to get this big trolley, which is not powered because it's broken, it's been broken for a long time, and load it all up with trays, porridge, bread, butter, everything and push it upstairs for the people that have room service.

PN1613

Just bear with me. I accept it's broken, the trolley. When you say you push it upstairs, you mean you actually push the trolley up the stairs?‑‑‑I push it up a ramp and into a lift and take it upstairs.

PN1614

Okay, that's okay. I was just - - -?‑‑‑Not up the stairs but upstairs.

PN1615

That's okay?‑‑‑Downstairs will have a - like a trolley set up with their trays so when they get Mr Smith up, Mr Smith ideally it's meant to when you've given somebody care, you come down and you get their breakfast nice and hot and you take it back to him, okay? And so on. It doesn't happen like that. I mean eventually when the home model works the way it's designed to work it'll be a beautiful thing, but at the moment it's - it doesn't work the way it's planned to work I don't think.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1616

That's okay. There's no trick questions here, I'm just trying to understand. So - - -?‑‑‑You know, the one way that you can really understand how we work, what we do is to come and work on the floor with us.

PN1617

Well, I - - -?‑‑‑You know, put an apron on - - -

PN1618

I don't think I have time this week, Ms Ellis?‑‑‑Right.

PN1619

But I'm happy for you to make contact with me if that will help me when the case finishes. So, there's a central kitchen and I take it there's a central dining room?‑‑‑Yes.

PN1620

And some residents are sufficiently ambulant to go to the dining room?‑‑‑Some are, some are assisted - - -

PN1621

I'm not suggesting it's a lot but some are and - - -?‑‑‑Some are assisted to come down, some are brought down in wheelchairs, some in care chairs.

PN1622

Yes. So, if you're ambulant enough to get down or you're assisted down?‑‑‑Yes.

PN1623

You might very well have breakfast, lunch and dinner in the dining room. Is that right?‑‑‑Some people come down for all meals, yes.

PN1624

Yes. However, for those who aren't coming down, you go down to the central kitchen, load up a trolley of meals and take it back to Wattle or wherever you are?‑‑‑Yes, upstairs to Magnolia.

PN1625

Yes, to Magnolia. And do you then hand out those meals to the residents?‑‑‑Correct.

PN1626

And as might be the case, you and your staff might have to help feed some of the residents who have higher acuity?‑‑‑Yes.

PN1627

Some of the residents might be able to eat themselves and that's how they - - -?‑‑‑Yes. Some residents want scrambled eggs, some residents want their toast lightly toasted or they'll buzz, you know, it's cooked too much. They all have their own little routines. It's very much individualised person-centred care. And we try our best to make sure that we do that but it's very difficult at times.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1628

Ms Ellis, I don't think anybody's suggesting you don't do your best. I'm being serious. I don't think they are?‑‑‑No, well, I know we do our best, you know.

PN1629

You say in your statement and perhaps it's lucky you've got a Certificate III in Commercial Cookery. You say in your statement that you also cook?‑‑‑I do.

PN1630

No, that's fine. Do you use the kitchenette to cook?‑‑‑The kitchenette off the main kitchen and I use the kitchen upstairs in Magnolia. Up - - -

PN1631

Now - go on?‑‑‑The kitchen upstairs in Magnolia I will cook the scrambled eggs that people request or the poached eggs or the fried eggs and then at dinner time it'll be - some residents require omelettes, grilled cheese and tomato on toast, different things like that. So, I use that kitchen for that.

PN1632

Is that because the main kitchen doesn't provide those things?‑‑‑The residents don't like the food that's provided, they're sick of casseroles and sloppy foods, as they say, and they won't eat it. So we try to think well, what can we do to help you eat? What do you feel like?

PN1633

Right. And so you and your team, if somebody doesn't want to eat food from the central kitchen, in the homemaker model you and your team might prepare an omelette or some scrambled eggs for them actually in Magnolia?‑‑‑Correct. Because it's a long time - you know, like their dinner's at 5 o'clock, it's a long time to go until the next morning without food. So it's good that they try and have something to eat.

PN1634

Yes?‑‑‑And then if I use the kitchen downstairs I normally do that when I'm doing activities, because as soon as they start smelling food cooking they all come down, and we had so much more room and then we all participate in that.

PN1635

I think that's part of the homemaker model, isn't it?‑‑‑Correct, activities and all, yes.

PN1636

Can I take you to paragraph 113. I will try not to keep you much longer, Ms Ellis?‑‑‑Okay.

PN1637

In paragraph 113 you talk about cleaning duties. I just want to - first of all this is all in the context of the homemaker model, this evidence, is it?‑‑‑Yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1638

Yes, okay, that's fine. Am I right or wrong, does Uniting have separate cleaners?‑‑‑They do, they have contracted cleaners. We have one cleaner in (indistinct) Lodge, one cleaner, and we've been in lockdown for 14 days with COVID. We've been in lockdown for the last two years, but the last 14 days we've still only had one cleaner.

PN1639

Okay, that's fine. But my question is they do have specialist cleaners to clean?‑‑‑I wouldn't call them specialist, but they have (indistinct) cleaner. They have (indistinct) that comes in, yes, and she does - - -

PN1640

I take it you don't think much of the cleaners?‑‑‑No, she's a really nice person. I don't understand a lot what she says to me and just all right, (indistinct), that's fine, you know - - -

PN1641

There is a contract cleaner who's meant to come in?‑‑‑There is a contract cleaner, yes, one contract cleaner.

PN1642

Okay, that's fine, I understand there's only one. I understand that. You then talk about activities at page 118?‑‑‑Yes.

PN1643

Does your set-up, your facility, does it have a recreational officer or somebody like that?‑‑‑It has a lifestyle and leisure officer, it has one.

PN1644

And that lifestyle and leisure officer do they have a Certificate IV or - - -?‑‑‑I don't know what she has. I imagine she has a lifestyle and leisure certificate, but I don't know.

PN1645

You don't know. That's fine. That's fine if you don't know. And does the lifestyle and leisure officer organise the activities for the residents?‑‑‑No.

PN1646

Do they design the activities for the residents?‑‑‑She writes all the activities up on a calendar and puts the calendar out. Before she does that calendar she always - anything you want on that calendar, can you do this, can you do that. She designs the calendar around my work days because I'm one for really wanting people to do things. You just can't spend every day of your life in four walls, you know, you need - I would go crazy, they must go crazy. So, you know, I'm up for any kind of activity we can do. I come up with lots of different things and they love them, they love being busy.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1647

So your evidence is that separately to the recreational lifestyle officer you also organise activities separately?‑‑‑I would say the homemaker does 90 per cent of the activities. Well, we do all the activities. We contribute. It's all us I think. You know, sorry, Nic, but she really doesn't - you know, I'll send her a message or an email, you know, we need supplies for cooking, we need supplies for bingo. It still won't come.

PN1648

So in your case the recreational lifestyle officer is not actually doing a lot in terms of organising activities, you do that, do you?‑‑‑Yes. She doesn't do any of the activities face to face. She might have a lot to do, I don't know what she does, what her role is. I think she's busy working in admin and all that, but the activities come down to us. The residents come to us, 'What are we doing today? What we want to do today.'

PN1649

Is this just you or does everybody who works at your facility are they the same with activities?‑‑‑To be quite honest I don't think we have a great lot of homemakers left at the moment. They're all a little bit overwhelmed with the job, some off on workers comp, and we have a lot of fill in homemakers. I helped a young, a new young homemaker out over Easter in Jacaranda because she had no idea and wasn't sure what to do. So I set her up with some activities and - I did the best that I could considering we had no printers working in the facility.

PN1650

That's fine, and when you say the best that you could I take it that you're helped by holding a Certificate IV in lifestyle and leisure?‑‑‑Probably. I mean if we had not have been in lockdown in (indistinct) Lodge I was going to tell her - well, I suggested, I didn't even think about that, that she couldn't come, come over and cook hot cross buns. I made freshly cooked hot cross buns for our residents to make sure they had hot cross buns and all that. Even this Anzac Day the kitchen had a malfunction, and apparently all our Anzac biscuits tasted terrible. The cook in there said, 'We tried and we all got tummy pains, so we've thrown them away, can you do anything?' So because we were in lockdown I could do maybe two residents or one on one, and there's a couple of other ladies that really love cooking. I said, 'Are you up to make Anzac biscuits for this afternoon?' So that after lunch the three of us got in and we pumped out 120 Anzac biscuits, which - - -

PN1651

I take it that holding your Certificate IV in lifestyle and leisure you were actually taught how to plan leisure activities for people?‑‑‑Correct.

PN1652

Is that correct? Yes. And were you taught how to actually undertake them?‑‑‑Yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1653

Can I ask you to go to paragraph 153 - sorry, 154, my apologies, Ms Ellis. Paragraph 154 starts with, 'I've taken a few hits in the dementia ward.' We're moving back now to when we talked about the dementia ward earlier. That's (indistinct) for that part of your evidence?‑‑‑Yes, and, you know, only a few weeks ago I got, you know, like - I don't know what you call it - somebody's arm right up against you trying to get out, an ex police officer, very much demented, very unstable on his feet. Somebody came in and he barged to the door to get out and I mean, you know, like he put his arm up, and I just had to go with him, and I went out the door, okay, let's keep walking, and I rang for back-up, can somebody bring a wheelchair, or at least his walking frame and assist me, because we were heading up the highway.

PN1654

Fine. And I assume I'm right there when you do your Certificate III you're actually taught de-escalation strategies?‑‑‑Look, I don't remember being taught anything like that. I - - -

PN1655

You don't remember being taught anything to do with de-escalation of troubling or aggressive behaviour?‑‑‑Back to my Cert III I think it was - I think back in Cert III it was mainly just washing and drying and just, you know, feeding. I can't remember - I don't remember my course back all that time ago, but it's something that I've learnt. I've done a lot of online dementia courses through the University of Tasmania and different mental health programs through Uniting, and different things like that. So working in the dementia ward, working anywhere you get to know - you get to know people, you get to know something's not right with Mr Smith today, you know, is he constipated, does he need to go to the bathroom, and so on.

PN1656

If you're in an unsafe situation do you have an alarm system?‑‑‑I would press the SOS call system. Hopefully it's working and hopefully somebody answers the buzzer.

PN1657

So if we assume for present purposes that it's actually working, and we assume somebody answers it, who's likely to answer it?‑‑‑Another staff member.

PN1658

Okay. When you press that do all the staff members who are available come to help?‑‑‑In theory, yes, but no.

PN1659

So you're often left just by yourself in an unsafe situation, are you?‑‑‑I'm left my myself in an unsafe situation hardly ever but, you know, there is times where it happens and I would yell anyway. Get my phone out of my pocket and I would ring. But you do learn strategies, you learn how to read people and, you know, not get yourself cornered into a room.

PN1660

If I can take you to page 173?‑‑‑Care plans?

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1661

Yes, yes, if I could. Am I right that this happens, when a resident is admitted the registered nurse will meet with the resident and the family and they will prepare a care plan for that resident. Is that correct?‑‑‑Normally when somebody arrives I will ring and let the RN know that so and so has arrived. She may not come immediately. We normally - - -

PN1662

So, you could have somebody admitted without the RN even knowing they're being admitted, could you?‑‑‑They would have received an email to say Mr Smith's arriving today but not be given a time. And then if he's coming with patient transport, they might arrive, we've got Mr Smith here, so we'll show them to his room. I'll ring the RN, but like I said the RN may not be available to come.

PN1663

No, that's okay. So, your evidence is that at your establishment you can have somebody admitted without a care plan of any kind?‑‑‑Well, I actually don't do the care plan, so when that person arrives I will do their weight, their blood pressure, all their set of obs. If it's a patient transport, they might hand over any medications, any paperwork and things like that. I'll let the physio know that so and so's arrived, we'll settle them in. Hopefully the RNs there by then and then can take over and I just hand it all to her.

PN1664

So, you - - -?‑‑‑Then we will do - then we'll do the bowel charts and they'll eventually go onto ACFI, I'll do the lifestyle and leisure.

PN1665

You've just said that you don't do the care plan. I take it - is it your understanding the registered nurse does the care plan?‑‑‑She does the care plan. We just give her the information to help her implement that care plan.

PN1666

Right, okay. And once the registered nurse has actually written the care plan, will she sit down with you and talk you through it?‑‑‑No.

PN1667

Your registered nurse doesn't do that?‑‑‑No.

PN1668

No, okay. Right?‑‑‑I'll either get an email; can we please take a photograph of Mr Smith, email it to the pharmacy and to admin. Again, that's all done with my phone or with - - -

PN1669

Okay. So, your registered nurse writes the care plan but what, does she just send it to you electronically and say read this yourself?‑‑‑No, we don't get anything like that.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1670

So, you don't get to read the care plan?‑‑‑I can read it if I go to the computer and have a look - look it up and have a look at it. Again, I will get to know the person by doing the B10, which is their lifestyle and leisure. Physio, which are subcontractors, they always come and tell us what their manual handling is and what they need.

PN1671

Okay. So, whether or not you read the care plan of a resident where you work is a matter for you, it's not required?‑‑‑No, nobody's ever told me I have to sit and read every care plan.

PN1672

No, that's fine, that's fine. In paragraph 173 you set out in detail what's in your care plans?‑‑‑Right.

PN1673

I take it that you've copied that from how your - what's on one of your care plans today?‑‑‑Well, personal care and hygiene we do. Oral care we do. Social and cultural, we do. The medication would be - - -

PN1674

No, that's - bear with me, that wasn't my question. Just bear with me?‑‑‑Okay.

PN1675

You say in paragraph 173:

PN1676

The plan covers the following care areas.

PN1677

?‑‑‑Yes.

PN1678

So, I assume you've taken somebody's care plan at your facility and those headings are on your care plans are they?‑‑‑No, like the other day we have a fairly new resident and I needed to sit and read her care plan because I needed a little bit of in-depth know about her. But I do not have time to sit down every day and read everybody's care plan. We might have to update them and change them and then I have a quick glance but every day for a new resident, we don't have the time.

PN1679

That's all right. Just bear with me. That wasn't quite what I was asking. I'll try again. I take it if you were to show me one of your care plans for a resident?‑‑‑Yes.

PN1680

A, b, c, d, e, f, g, h, i, j, k, l, m, n, o?‑‑‑Yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1681

Would they be the headings on the care plan?‑‑‑I guess so. I think - - -

PN1682

So, you don't know?‑‑‑Well, sleep would definitely be one. I don't know that - palliative would come under end of life. They all - - -

PN1683

So, you don't - - -?‑‑‑They all come under different things.

PN1684

Okay, so what is the document you've referred to, to tell us that your care plans cover these things?‑‑‑Well, I know that they cover all these things because we - these are the things that we report back on. You know, there's a spot in there for what their - because they're in the B10s.

PN1685

So, if I was to get one of your - - -?‑‑‑(Indistinct), sorry.

PN1686

If I was to get one of your care plans, I would probably somewhere find references to these things in it?‑‑‑Definitely. Like, oral care comes under personal care. And you might even find the continence, but these things are all - we all go over, yes.

PN1687

When you're writing your progress notes at the end of the day, or whenever you write them?‑‑‑Yes.

PN1688

Do they get shared with the RN?‑‑‑Yes.

PN1689

And am I right in saying that the RN will review those progress notes and decide if a care plan should change?‑‑‑Yes, or - like, for instance, Judy the other day, she had a choking fit. She wears a collar and she had a choking fit a few weeks ago, had to go to hospital, came back on a minced diet. Now, the dietician had told her that she can go back to a soft diet but she's been too scared. The other day she saw something that looked nice and she wanted to eat it. So, she said, 'Do you think I could try it?' So, knowing what her - how her plan has changed I said 'I think so but I will double check with the RN and we'll see how we go'. So, the RN and I came up with a plan yes, she could try it but one of us had to be with her in the dining room to make sure that she had no issues at lunch time, and you know, like the RN said 'If you don't have time to update the care plan, I will do it after she's had lunch to see how she went'. I said, 'Okay'. So one of us would do it, yes.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1690

Okay. But you're not authorised to change a care plan, the RN's authorised to change a care plan?‑‑‑Yes, we can go in, we can edit and do little things and it brings up a little box and we can put things in.

PN1691

What do you mean by little things?‑‑‑Well, like I just - with her - with her meal, she wanted to try a soft diet.

PN1692

That's okay, but in that example - in that example, the RN authorised that to happen didn't they?‑‑‑Correct. I wouldn't do anything without letting the RN know first.

PN1693

Thank you?‑‑‑That we're going to change that, yes.

PN1694

Thank you. I'm going to do this very quickly. Sorry, Ms Ellis, I've kept you longer than I should?‑‑‑(Indistinct reply)

PN1695

I'm not sure the Commissioner's going to feel that way. You've made a second statement, haven't you?‑‑‑Yes.

PN1696

My understanding of your second statement in large measure is that it - you've read some statements from people who work at Warragul?‑‑‑Yes.

PN1697

You've commented on those, haven't you?‑‑‑Yes.

PN1698

Yes. Am I right that you've never worked at Warragul?‑‑‑I'm not even sure where it's located.

PN1699

Right. So, when you comment on what they've said, you're not saying from your knowledge that they're wrong, are you?‑‑‑No.

PN1700

No. As I understand it, what you're saying is you've read what they've said, you've tried to transfer that into your workplace and you've made some comment about your workplace?‑‑‑Correct.

PN1701

Yes. And you have worked at Buckland because you've commented on that but you haven't worked at Buckland since 2009, have you?‑‑‑No.

PN1702

So, I take it you're not saying that the evidence from Mr Brockhouse given in 2020 is wrong either, are you?‑‑‑No, I - no, I haven't worked at Buckland's for a long time.

***�� VIRGINIA ELLIS�� XXN MR WARD

PN1703

No. So, the answer's no?‑‑‑Yes.

PN1704

Thank you. Just a moment if I can, Commissioner. Thank you, Ms Ellis. You've been very patient with me, thank you very much. No further questions.

PN1705

COMMISSIONER O'NEILL: Thank you for that. Mr McKenna, did you have any questions for Ms Ellis?

PN1706

MR McKENNA: No, thank you, Commissioner.

PN1707

COMMISSIONER O'NEILL: I was just checking you're still awake. Mr Gibian, anything in re-examination?

PN1708

MR GIBIAN: Yes, thank you, Commissioner.

RE-EXAMINATION BY MR GIBIAN�� [12.27 PM]

PN1709

MR GIBIAN: Ms Ellis, can you hear me?‑‑‑Yes.

PN1710

Now, there were just a few matters that I wanted to raise with you. You were asked initially about obtaining a Certificate III in Aged Care?‑‑‑Yes.

PN1711

And indeed the Certificate IV and I think you said with respect to both that they were something that you wanted to do to improve your qualifications?‑‑‑Yes.

PN1712

When you did the Certificate III, which I think you said was around 2008 or so, were you already working at Buckland by that point?‑‑‑No, I wasn't. I wanted a change, yes.

PN1713

So you did it before you went into aged care?‑‑‑I did.

PN1714

You were then asked some questions about the content of the Certificate III course that you did quite some time ago now. I think you were specifically asked some questions about - it was by reference to paragraph 34(d) in your first statement on page 10007 of the digital court book. I think you agreed that you'd recalled doing or having some instruction in relation to dressing and bathing?‑‑‑Yes.

***�� VIRGINIA ELLIS�� RXN MR GIBIAN

PN1715

But I think your answer was that you didn't recall any instruction in relation to skin integrity issues or excoriations, bruising, et cetera. I just wanted to ask whether to the best of your recollection you did not have instruction on that in those matters in doing the Certificate III?‑‑‑I just don't recall. It's that long ago.

PN1716

I understand?‑‑‑I would have to go find my course notes, if I still had them.

PN1717

Yes?‑‑‑And look it up.

PN1718

You then were asked some questions both about Wattle and Magnolia, the different locations, and you were asked about whether you had residents with dementia and who were bedridden and the like. I think you also mentioned residents who you referred to as bi twos?‑‑‑Yes.

PN1719

What is that a reference to?‑‑‑That means two staff to assist that resident. We had one lady in Wattle that was actually bi three or four at times, which - that's your whole team on that floor gone, could be for 20 minutes, to try and transfer and things like that.

PN1720

When you say two people to assist, to assist to do what?‑‑‑It could be to transfer her, move her in the bed, to dress her, to get the lifter on her. Once they're set up in their chair or whatever, then they will become like a one person to take their meal and all that. But if she requires to get up or anything, it becomes two, maybe three.

PN1721

You were then asked some questions about handover and your reference to reading a communications book and to progress notes. I just wanted to ask you, is the communications book a physical book?‑‑‑Yes, it's a book.

PN1722

And is that separate from the progress notes which I'd understood you described as being put in the computer system?‑‑‑That's correct. The book is there for all staff to read. So if night shift leaves something, something happened in the middle of the night or somebody has said, 'I'm going out', they might leave a note to say, 'So and so is going out at 10 am, can they be ready', and so on. Day staff will come on, see that, I'll see that.

***�� VIRGINIA ELLIS�� RXN MR GIBIAN

PN1723

You were asked some questions about administration of medications, both schedule 4 and schedule 8 medications. When answering a question in relation to schedule 8 medications you referred to difficulties that were encountered in the administration of medications where the registered nurse was a person who was an agency nurse or someone with whom the resident was not familiar. Do you recall saying that?‑‑‑Yes.

PN1724

How often is it that you're working with a registered nurse who is an agency nurse or not regular at the facility?‑‑‑The last few months we've had pretty much the same set of RNs, which is good. During the height of COVID we had a lot of agency RNs and even if it's an RN that's Uniting staff working Jacaranda and they've had to come over, sometimes the resident just doesn't know them and is unfamiliar with them and they just don't want to - maybe it's just at trust thing. They don't know them, they're just concerned - and they know us and they trust us.

PN1725

I understand. You were then asked some questions about recording the medications on the chart on - and you referred to the chart on their file on the computer system, I think?‑‑‑It's an EMS. That's the - sorry, I get what you mean: not the medication chart, the chart on their file, yes. If you bring up somebody's name it will have their profile, then you'll have progress notes, forms and files, charts, tasks and things like that so you just click on the chart and there will be a drop-down box. That's where you find them.

PN1726

That may have answered the question I was going to ask, which was the chart, the medication chart is separate to the progress notes, is it, at least on the resident's file?‑‑‑Yes, you would have to go to the resident's medication and you'll find their list but then we have that printed out in a separate file downstairs so if the EMS goes on the blink we've got a paper copy. But on the EMS, which is the mobile tablet, it's got their medication chart so everything they have, their (indistinct), everything's listed there. That's what I work off. Sometimes there's (indistinct) - - -

PN1727

I'm sorry?‑‑‑Sometimes there'll be - like a lot of people just recently are on that anti-viral COVID drug but it wasn't on their EMS. So then I would go back to the RN: 'This is there for them but it's not charted', then we would have to go to a paper chart.

PN1728

On the computer system under the file of each resident, are there other charts and files that need to be maintained?‑‑‑There's lots of different charts and files. There's, you know, your bladder, your bowels, pain, the 12.3, which is the care staff massage. There's heaps of them: fluid out, fluid in, food charts, their care plans, which, you know, can be edited and updated and things like that.

PN1729

All right. In relation to the medications, you were asked about how the Webster-pak process works. In your statement you've referred to also administering creams, eye drops and lotions and other matters. Are they dealt with in the Webster-paks as well?‑‑‑The eye drops and all that will be packed in our medication trolley.

***�� VIRGINIA ELLIS�� RXN MR GIBIAN

PN1730

When do you do those?‑‑‑Normally as I'm going, so I'm giving their medications. You know, some people might have Flamazine on their legs so I try to do it as I go.

PN1731

You refer to circumstances in which medication was refused and I think in answer to one of the questions you said that you would try for half an hour or so to see if you could administer the medication. What types of techniques do you use where there is some difficulty with a resident taking the medication?‑‑‑Sometimes they might just need to finish their breakfast of what they're doing and then come back and just start off, for like a whole new day, groundhog day, and sometimes they'll just take it. Sometimes they won't take it. I might ask a different staff member, 'Can you try' - things like that.

PN1732

You were asked some questions about the lifestyle and leisure officer. I just wanted to ask is there one lifestyle and leisure officer for the whole facility?‑‑‑Yes.

PN1733

You then were asked some questions in relation to the care plans. In the context of referring to the care plans you referred to completing what was referred to as a B10?‑‑‑Yes.

PN1734

Can you explain what that is?‑‑‑B10 is lifestyle and leisure so it's getting a picture of what the person likes and dislikes, what hobbies they might like to do, what their ideal day would be like - when would they like a shower, how often would they like a shower, what they like to eat, have they got family, is there anything they don't want, do they not want birthdays brought up. It's just a general what makes that person I suppose function, keep them happy, what they � do they want to vote, do they not want to vote.

PN1735

Who completes that?‑‑‑I do.

PN1736

Is it part of - - -?‑‑‑I do my section.

PN1737

Is it part of the care plan, or separate from the care plan?‑‑‑It's separate from the care plan. So all our charts go up and then I imagine the RN, or whoever completes the care plans, would look at that and see what the (indistinct) is, and things like that.

***�� VIRGINIA ELLIS�� RXN MR GIBIAN

PN1738

And it may vary from person to person perhaps, but how long are most of the care plans, that is, are they a number of pages or � are you able to comment on the length of care plans?‑‑‑I imagine they're a couple of pages, but, you know, I scan through them. It's just on the computer. We just scroll down.

PN1739

That is, you don't print them out; you just view them on a screen?‑‑‑Yes. There'd be tens of four or pages long.

PN1740

Thank you, Ms Ellis. Those were the matters that I wanted to clarify?‑‑‑Thank you.

PN1741

COMMISSIONER O'NEILL: Thank you very much for your evidence today, Ms Ellis. You are now free to leave if you wish to?‑‑‑Thank you.

<THE WITNESS WITHDREW�� [12.38 PM]

PN1742

COMMISSIONER O'NEILL: Are we ready to proceed with Ms Gilchrist?

PN1743

MR GIBIAN: Commissioner, I think we communicated to Mr Ward's people that we were proposing to move forward Ms Kelly, who was meant to be after Ms Gilchrist, because of an issue she has. I don't know whether Mr Ward's estimates have changed, but we also really do need Ms Kelly to be finished before we have lunch, and I don't know whether that would impose upon the Commission or indeed the other parties if we extend somewhat beyond 1 o'clock if that is necessary for Ms Kelly to be completed. She has some care obligations so far as her sister is concerned, who has recently had surgery.

PN1744

COMMISSIONER O'NEILL: That's fine. Mr Ward, how long do you think you'll be?

PN1745

MR WARD: Given what I've just heard, I will truncate this to make sure it fits, Commissioner.

PN1746

COMMISSIONER O'NEILL: Terrific. All right, then - - -

PN1747

MR GIBIAN: That's greatly appreciated. She is calling in externally, so I think � yes, we have her now.

PN1748

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

***�� VIRGINIA ELLIS�� RXN MR GIBIAN

PN1749

MS KELLY: Donna Louise Kelly, 42 Lovett Street, Devonport, Tasmania, 7310.

<DONNA LOUISE KELLY, AFFIRMED�� [12.39 PM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [12.40 PM]

PN1750

COMMISSIONER O'NEILL: Yes, Mr Gibian.

PN1751

MR GIBIAN: Yes. Thank you, Ms Kelly. Can you hear me also?‑‑‑Yes.

PN1752

Could I just ask you then to repeat your full name for the record?‑‑‑Donna Louise Kelly.

PN1753

And you're an extended care assistant at Baptcare Karingal Community Care in Devonport?‑‑‑Yes.

PN1754

You've made two statements for the purpose of these proceedings. The first of those is dated 31 March 2021. Do you have a copy of that with you?‑‑‑Yes.

PN1755

It's probably the somewhat longer one. It's 10 pages and 46 paragraphs?‑‑‑Yes.

PN1756

Have you had an opportunity to read through that?‑‑‑Yes.

PN1757

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

PN1758

Thank you, Commissioner. We seek to rely upon that statement. It's document 161 commencing at page 10406. There was a further statement headed, 'Reply witness statement of Donna Kelly', dated I think 20 April 2022. Do you have a copy of that also, Ms Kelly?‑‑‑I do.

PN1759

Have you also had an opportunity to read that and is it true and correct to the best of your knowledge and recollection?‑‑‑Yes.

PN1760

That, Commissioner, is document 162, starting at page 10416 of the digital court book, and we also seek to rely upon that statement. There was just one matter I wanted to clarify with Ms Kelly. Ms Kelly, can I ask you to turn to your first statement in paragraph 39 of the statement of 31 March 2021? It's on page 10414 of the digital court book. Do you have that?‑‑‑Is that under the medication provisions?

***�� DONNA LOUISE KELLY�� XN MR GIBIAN

PN1761

Yes. You'll see immediately under the heading, 'Medical provisions', in bold in the first sentence, you refer to having done a medication course through work. Do you see that?‑‑‑Yes.

PN1762

Could I just ask you if you could describe what that medication course was?‑‑‑That was � well, like I said there was an accredited course through a training provider, which work provided for us.

PN1763

What was involved in it, in brief at least?‑‑‑I had to do a classroom course with a trainer, and then at the completion of that had to do competency training on the floor with either the RN or the NUM over a specific term.

PN1764

That is, over a period of time?‑‑‑Yes.

PN1765

Was there a written test associated with the classroom part of it?‑‑‑I can't really remember a test. There were some assignments that had to be completed.

PN1766

Yes, maybe that was what I was thinking of. When did you do that, approximately at least?‑‑‑I was written up on that in � so I did the course in 2013 and I received the certificate in January 2014.

PN1767

Thank you, Ms Kelly. You'll see on the screen in front of you I hope, one of the squares is Mr Ward, who is now going to ask you some questions?‑‑‑Okay.

CROSS-EXAMINATION BY MR WARD�� [12.44 PM]

PN1768

MR WARD: Ms Kelly, I understand that you need to get off, so I'm going to keep you for a short moment, not a long one, so please rest assured you'll get off for lunch. My name is Nigel Ward, Ms Kelly, and I appear in these proceedings for the employer interests, so just understand that that's where I come from. I've got about half a dozen questions. That's all I've got to ask. Can I just start with the registered trained auxiliary nurse qualification?‑‑‑Yes.

PN1769

It's not a qualification I'd heard of before. Are you able just to explain is it a Certificate III or is it a university qualification, what qualification is it?‑‑‑So this was out of the training hospital in Tasmania, psychiatric hospital, which is now closed, and I'm assuming the majority of certificates received within that time have now changed classification. So it was a two‑year course, one block in, three blocks on the ward. At the end of that had to sit exams, and then, because I passed, they were registered with the Nursing Board.

***�� DONNA LOUISE KELLY�� XXN MR WARD

PN1770

And if you can't answer this I appreciate it, but does that mean you're a registered nurse?‑‑‑Yes.

PN1771

Okay?‑‑‑Not as how we see it now. A registered nurse did three years. I only did two years of training, so it was one level below I suppose, you could say.

PN1772

Do you hold accreditation as a registered nurse now?‑‑‑No.

PN1773

I'm not trying to be difficult with you, I'm just trying to understand. Do you hold accreditation as an enrolled nurse?‑‑‑Yes � no, not now.

PN1774

You hold some nursing accreditation?‑‑‑As an extended care assistant. I did a Certificate III through TAFE.

PN1775

That's fine. Again, I'm just trying to understand. Your title is an 'extended care assistant'?‑‑‑Yes.

PN1776

I've seen lots of care assistants in this case, but I haven't seen an extended one. Is that just a name your employer uses, or does that mean something I need to understand?‑‑‑It's probably something I need to understand. I don't know. That's just - - -

PN1777

You're a care worker with a Certificate III?‑‑‑Yes.

PN1778

I don't mean that in a disparaging way but that's your role?‑‑‑Yes.

PN1779

No, that's fine, that's fine. Can I just touch on the issue that Mr Gibian had a go at. Can I take you to paragraph 17. You say there that you obtained the Administration of Medication Competency in 2013 and you go on to say - - -?‑‑‑(Indistinct reply)

PN1780

'The duration of the course' - sorry?‑‑‑(Indistinct) competency.

PN1781

Continued:

***�� DONNA LOUISE KELLY�� XXN MR WARD

PN1782

The duration of the course was approximately six months. At first I attended one day of classes per week, but then I started competency training on the floor.

PN1783

Do you know whether or not in 2013 - do you understand whether or not that was a Certificate II or a Graduate Certificate program?‑‑‑No, I can see that there. Those - let me have a look. The certificate was supplied by Australian Employment and Training Solutions.

PN1784

MR GIBIAN: I think Mr Ward might have - no, he's back.

PN1785

COMMISSIONER O'NEILL: He's back.

PN1786

MR GIBIAN: I think Mr Ward had frozen for a period of time on our screen at least. I'm not sure whether that was common to others.

PN1787

MR WARD: I'm just very good at standing terribly still, Mr Gibian. I did freeze. Thank you for letting me know. Sorry, Ms Kelly. Let me ask it a different way. Do you have a copy of your Certificate III?‑‑‑Yes.

PN1788

Commissioner, can I - can I call for that? I don't know how you do that virtually but if Ms Kelly can provide a copy to be put on the record, I think that might help us.

PN1789

COMMISSIONER O'NEILL: Ms Kelly, would you be able to provide a copy of that document to the HSU?‑‑‑Yes.

PN1790

Mr Gibian, are you content with that?‑‑‑Yes.

PN1791

MR GIBIAN: Of course. I don't think we can do it in real time necessarily but we can (indistinct) provide it.

PN1792

MR WARD: No, no.

PN1793

COMMISSIONER O'NEILL: We will arrange for that to be included in the hearing book.

***�� DONNA LOUISE KELLY�� XXN MR WARD

PN1794

MR WARD: Thank you. Thank you, Ms Kelly. Now, you say in your statement that you don't do Schedule 8 medications. That's correct?‑‑‑Pardon, what was that?

PN1795

You say in your statement you don't administer Schedule 8 medications?‑‑‑No.

PN1796

But you do administer Schedule 4?‑‑‑I'm not sure.

PN1797

You do administer some medications?‑‑‑Yes.

PN1798

That's all right. Where you work, I assume that the tablet medications are in Webster-paks or something similar?‑‑‑They were to begin with but now they're in - they're supplied by the chemist in sachets.

PN1799

And we've not heard that term before in this case. Can you tell me what the difference between a sachet and a Webster-pak is?‑‑‑So, sachets are little envelopes designated for each timeframe of the day that the resident has the medication and they are sent to the facility for the week.

PN1800

Okay. So, if I am a resident it might be the sort of the 10 o'clock, the 12 o'clock, the 2 o'clock for me?‑‑‑Yes. And there'll be for the - for the whole - for the seven days.

PN1801

That's okay. When they arrive at your facility, does the RN take control of them?‑‑‑Yes.

PN1802

And I assume that they're kept under lock and key?‑‑‑Yes.

PN1803

The RN takes them out and puts them on a medication trolley?‑‑‑Yes.

PN1804

You then take the medication trolley for the medication round?‑‑‑Yes.

PN1805

Am I right that when you arrive at a resident, I take it that you have to verify the medications are correct?‑‑‑Yes.

PN1806

Am I right that you would do that by looking at the name of the medications against a check sheet?‑‑‑Yes.

***�� DONNA LOUISE KELLY�� XXN MR WARD

PN1807

And you would also have a picture chart to see what the medication should look like?‑‑‑No, not - some, yes, some, no, but there's usually a description on the sachet of what I should be looking for.

PN1808

If you see something that looks wrong, do you go to the RN?‑‑‑Yes.

PN1809

On your sachets, we heard evidence this morning that often on the Webster-pak, how the medication is to be administered is written on the Webster-pak. Is it written on your sachets?‑‑‑No.

PN1810

So, how do you know whether or not somebody can take it whole or whether or not it needs to be crushed and put into custard?‑‑‑So, the indications for taking the medication is usually on the iPad, so the iPad is more or less just a reflection of the drug chart.

PN1811

Yes. So, that will indicate how the resident is to take the medication?‑‑‑Yes.

PN1812

That's fine. I take it after you've given the medication, you observe they've taken it?‑‑‑Yes.

PN1813

And then you enter on the iPad confirming that they've taken it?‑‑‑Yes.

PN1814

Can I take you to - sorry, can I just confirm, I think you told Mr Gibian this. In paragraph 39 when you say, 'I did a medication course', that's the course in 17 isn't it? You've only done one medication course?‑‑‑Yes. And every 12 months we do a competency within the facility.

PN1815

And who oversees that?‑‑‑The RN or the NUM. Usually the RN will observe myself giving the medication and include anything she needs - thinks that I should have done or not done and then it's passed onto the NUM to sign off.

PN1816

She'll verify your competency each year by joining you on a medication round?‑‑‑Yes.

PN1817

And basically watching you do it?‑‑‑Yes.

PN1818

Yes, okay. I take it you report to the registered nurse?‑‑‑Yes.

***�� DONNA LOUISE KELLY�� XXN MR WARD

PN1819

The registered nurse reports to the nurse unit manager. Is that right?‑‑‑Yes.

PN1820

I've only got a couple more and I'll have you on your way. Could I ask you to go to page 21?‑‑‑Page 21?

PN1821

Sorry, my apologies, paragraph 21, sorry. I'm sorry?‑‑‑Yes.

PN1822

You say there:

PN1823

I am usually allocated six or seven residents.

PN1824

?‑‑‑Yes.

PN1825

Am I right that you normally look after the same people or could that be - - -?‑‑‑No.

PN1826

You don't?‑‑‑No.

PN1827

So, how many residents do you have in all?‑‑‑Where I normally work there are 32 residents, so we'll be assigned a list and I don't have the same list each time I'm there.

PN1828

Is it just randomly allocated to you each day or - - -?‑‑‑I don't - possibly.

PN1829

Who works - who works - - -?‑‑‑It sometimes - it sometimes depends what shift you're on as well. If there's a list there with a few shorter residents the earliest staff members knocking off say 11 o'clock, they'll be given a bit shorter list. Those of us staying on till 3 o'clock will probably get the more involved list. It just depends I suppose on what shift you're doing on the day as to what list you get.

PN1830

Am I right in saying that you know the 32 residents reasonably well?‑‑‑Yes.

PN1831

In paragraph 21(m) you talk about cleaning bathrooms. I'll just let you see that?‑‑‑(m), did you say?

***�� DONNA LOUISE KELLY�� XXN MR WARD

PN1832

Yes, (m) starts with, 'I then clean the bathroom'?‑‑‑Yes.

PN1833

Does your facility have cleaners?‑‑‑Yes.

PN1834

So, do they do the major cleaning and you do spot cleaning?‑‑‑Yes. They do - what I'm saying there is once that bathroom's been used well, you're going to have to wipe up the water. If the resident goes back in there, there's a risk that they're going to have a fall. So, you know, yes, we've got to make sure that all that's safe for them, restocked, and, yes, the cleaners will go in, they'll do the toilet, the hand basin, the mirror. They will empty the garbage bins, but if the resident has a continence aid in there they won't, that's my job.

PN1835

Just bear with me. So if you see - I'm not trying to be demeaning - if you see a small splash of water on the floor you'll clean it up yourself?‑‑‑It's got to be done.

PN1836

If it was a major spill would you call the cleaner?‑‑‑It depends what's caused the major spill I suppose. If there's a leak - if it's only from the shower then that's my job to clean up.

PN1837

Can you go to paragraph 21(kk)?‑‑‑K did you say? No.

PN1838

I think it's (kk). On my document it says page 6?‑‑‑Yes.

PN1839

You say here:

PN1840

I will then do a quick tidy up of the dining room by scraping dirty plates, wiping tables, throwing leftover food - - -

PN1841

Am I right that you don't have kitchen staff to do that?‑‑‑Yes, we have kitchen staff, but once they've delivered the meals and they've collected any plates that are left in the rooms within their timeframe anything that's left that's my job.

PN1842

So if there's a plate left in the dining room that's your job, it's not theirs?‑‑‑That's right.

***�� DONNA LOUISE KELLY�� XXN MR WARD

PN1843

When you say 'in their time' what do you mean by 'in their time'?‑‑‑Well, they only have a certain time to deliver the meals, get back to the kitchen, I don't know what they do there; they come back, they collect what plates from residents who have had their lunch, and then they're back to the kitchen to do whatever it is they do, but whatever - whatever is left that's our job. And normally as we're in this particular dining room most of those residents are served by carer staff. So we are always delivering one meal at a time. So when they finish one meal then we've got to remove that plate, clean it, stack it on a tray or whatever we can find, and then deliver the second meal. So each time - - -

PN1844

When they're eating you might be assisting them with their eating, mightn't you?‑‑‑Yes.

PN1845

And what you're telling us is that when they have finished eating the kitchen staff don't clean up from them, you do?‑‑‑Those particular residents, yes.

PN1846

I am just trying to understand which particular residents that would be?‑‑‑So this is a smaller lunch - dining area in one of the areas I work where all those residents need assistance of some description, and they are only served one course at a time. As they finish a course it's my job to take away say their first course plate. If the kitchen's gone then I scrape the plates, stack them. Then if the kitchen are able to come back then it would be for them. If they don't we normally put them on a trolley and we'll wait until later in the day to return them to the kitchen.

PN1847

That's fine. You're talking here about a dining room separate to your main dining room, are you?‑‑‑Yes, there are two dining rooms within the facility. Each area has a smaller dining room for residents that need a lot more assistance than others.

PN1848

And this evidence that we're talking about relates to that smaller dining room?‑‑‑Yes. I very rarely - I'm very rarely in the larger dining room. The same can happen there, the residents finish their meal and the kitchen aren't able to get to the table, then one of the carer staff will remove the plates so they're ready for the second course.

PN1849

Your evidence in your statement is about the small dining room?‑‑‑Yes.

PN1850

I have no further questions, Commissioner.

PN1851

THE WITNESS: No, that's fine.

PN1852

COMMISSIONER O'NEILL: Thank you. Mr McKenna, you can just shake your head if there's nothing. Okay, lovely. Anything in re-examination, Mr Gibian?

PN1853

MR GIBIAN: No, there's not, thank you, Commissioner.

***�� DONNA LOUISE KELLY�� XXN MR WARD

PN1854

COMMISSIONER O'NEILL: All right. Well, thank you very much for your evidence, Ms Kelly. I understand you've got places you need to be, so you're absolutely free to go?‑‑‑Thank you very much.

<THE WITNESS WITHDREW�� [1.02 PM]

PN1855

COMMISSIONER O'NEILL: Well, this is perfect timing then for lunch. In light of the progress is there a request for a shorter lunch break to give us more opportunity to get through the afternoon, or you're content to leave it as it is. Mr Gibian?

PN1856

MR GIBIAN: I'm entirely in the Commission's hands. We're certainly happy to return say at 1.45 if that is convenient to the other parties. I might just indicate, we will have to give some consideration to it over lunch, there are still six witnesses having got through four so far that were scheduled for today. If we're going to push anyone back we will push Ms Peacock back to another day if we can't get to everyone, just because she now works for the union, so we can make her a bit more flexible than other people without interrupting their lives in any great sense. But we might see how we're going if that doesn't cause anybody too much difficulty.

PN1857

COMMISSIONER O'NEILL: All right. Does anyone have a problem with a 1.45 resumption? All right, that's what we shall do. The Commission is adjourned and we will resume at 1.45.

LUNCHEON ADJOURNMENT�� [1.03 PM]

RESUMED�� [1.46 PM]

PN1858

COMMISSIONER O'NEILL: Mr Gibian.

PN1859

MR GIBIAN: Thank you. The next witness is Jade Gilchrist who I think is on the screen.

PN1860

COMMISSIONER O'NEILL: Good afternoon, Ms Gilchrist. I'm O'Neill C, and my Associate's just going to have you take the affirmation.

PN1861

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

PN1862

MS GILCHRIST: My name is Jade Gilchrist. I have just started recently with Australian Services in Warwick. I think it's 37 Albion Street, Warwick, Queensland.

PN1863

COMMISSIONER O'NEILL: Ms Gilchrist, it's very hard to hear you, at least for me. Are you able to move a bit closer to the microphone?

PN1864

MS GILCHRIST: Sorry, is that better?

PN1865

COMMISSIONER O'NEILL: A little. If you can just try and keep speaking up.

PN1866

MS GILCHRIST: Okay. So I'm currently working for Australian Services. I'm based at the Warwick office on Albion Street in Warwick, Queensland.

<JADE GILCHRIST, AFFIRMED�� [1.47 PM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [1.47 PM]

PN1867

MR GIBIAN: Can I just inquire, Commissioner, whether that sound is satisfactory to you? I think I can make out most of what is being said but it's not easy to hear from my end at least.

PN1868

COMMISSIONER O'NEILL: It's not ideal but I'm not sure - is there anything you can see that you can change at your end, Ms Gilchrist?‑‑‑Let me have a look.

PN1869

MR GIBIAN: I mean it sounds like it's the connection to me. That's far from a professional opinion but that would be my guess rather than any actual physical item on the equipment. I think we'll - - -

PN1870

COMMISSIONER O'NEILL: If you can just - - -

PN1871

MR GIBIAN: I'm sorry, Commissioner.

PN1872

COMMISSIONER O'NEILL: We'll keep going but if you can really just try and speak loudly if you can, Ms Gilchrist, and if it becomes problematic perhaps anyone who's having troubles perhaps let me know?‑‑‑Okay. Otherwise I could try and sign in on my personal device. Would you like me to try that?

PN1873

I think we can just keep trying as we are and if we run into trouble we'll have that as a back up?‑‑‑Okay.

***�� JADE GILCHRIST�� XN MR GIBIAN

PN1874

MR GIBIAN: Thank you, Ms Gilchrist. Firstly, can I ask you to - this is Mark Gibian, I did speak to you but I don't think - we didn't see each other. Firstly, can I just get you to repeat your full name for the record?‑‑‑Jade Gilchrist.

PN1875

And I think you've just said but you're a lifestyle and volunteer coordinator for Clifton Community Health Service?‑‑‑That was my previous role.

PN1876

Okay. And sorry, can you update us then?‑‑‑Okay, so I have just gained employment with Australian Services in Warwick, Queensland. I've been here for two days.

PN1877

What's the role that you are with them?‑‑‑Customer service officer.

PN1878

All right. And you've made two statements for the purposes of the proceedings. You have both of those, do you?‑‑‑Yes, I do.

PN1879

The first is dated 30th - 31st, sorry, of March 2021 and is six pages and 48 paragraphs. Do you have a copy of that with you?‑‑‑Yes, I do.

PN1880

You've had an opportunity to read through it?‑‑‑Yes, I have.

PN1881

Is it true and correct to the best of your knowledge and recollection?‑‑‑There's only one amendment. Let me - in one case (indistinct) I was working for Uniting, however it's not the case.

PN1882

I'm sorry, I just missed that. Could I just ask you to repeat that last answer?

PN1883

COMMISSIONER O'NEILL: Just before you do, Ms Gilchrist. Mr Ward, it looks like you're really having trouble hearing as well, so we might have to try something else. Ms Gilchrist, you suggested that you might be able to connect in on your personal device?‑‑‑Yes.

PN1884

Are you able to see if you can do that now?‑‑‑Yes, I will.

PN1885

We can see two of you, Ms Gilchrist. Perhaps if you - - -

***�� JADE GILCHRIST�� XN MR GIBIAN

PN1886

MR GIBIAN: I think she now has to disconnect from the other. Sorry, perhaps Commissioner, you were going to say the same thing?‑‑‑Okay. All right, I've just shut the other one off. Can you hear me now?

PN1887

COMMISSIONER O'NEILL: That's better. Loud and clear, that's terrific?‑‑‑Okay. Excellent, all right.

PN1888

Mr Gibian.

PN1889

MR GIBIAN: Now I've forgotten where I was up to but I think you were just explaining the new position - sorry, you'd explained that and you were going to make one correction to the first statement, I think?‑‑‑Yes. I just don't know if it's the first or the second statement but in one of them I see there's a mention that - here we go. So, in the second statement in paragraph 8, under the heading of 'Technology', there is a reference to the word 'Uniting', which suggests that perhaps that was a workplace and it is not, so for the record it is Clifton Community Health Services and not Uniting, as mentioned on paragraph 8. That is the only correction at this time.

PN1890

That is the word - in the second, sorry, the third line of paragraph 8 of the reply statement, the word 'Uniting' should be replaced by Clifton Community Care. Is that right?‑‑‑Yes. Clifton Community Health Services, so that's - - -

PN1891

Community Health Services, I apologise?‑‑‑No problem. So, that's the only one that's jumped out at me when I've been reviewing that.

PN1892

Other than that, both of the statements are true and correct to the best of your knowledge and recollection?‑‑‑Yes, they are.

PN1893

They're the statements, Commissioner, which we seek to rely upon. The first is document 178, commencing at page 10597 and the statement in reply is document 179 commencing at page 10603. There was just one matter I was going to ask Ms Gilchrist to elaborate upon. Ms Gilchrist, do you have your first statement, that of 31 March?‑‑‑Yes.

PN1894

On the first page or towards the bottom of the first page in paragraph 8, you refer to having completed a research project on diversional therapy that had been recognised internationally. Do you see that?‑‑‑Yes, yes, I do.

***�� JADE GILCHRIST�� XN MR GIBIAN

PN1895

I just was going to ask you to describe the nature of that research project to the Commission?‑‑‑The nature of that research project was to - the title is, 'The impact of the baby boomers on diversional therapy practice'. The reason why I had conducted that research was to help our industry in moving forward in what to expect and how to prepare for the new generation of aged care recipients that will be coming across. The reason why this is of so much importance is that our industry has been formed while providing care for mainly the silent generation. With the baby boomer generation coming it presents a different type of service that we are going to need to provide so the research was basically to look at what type of services they would require, how that would change, how we would be able to implement that, how that would affect our ability to deliver services and basically what do we need to do to prepare so that was based on research that I did with the Diversional Therapy Australia with baby boomers, with informants, with some case studies and then that has been presented so I completed that research formally in 2019 and that was distributed amongst my peers as well as through available through Diversional Therapy Australia and anyone has access to that if they want. If has gained some international recognition, first Japan. So the diversional therapy president of Japan has also been sharing that research over in Japan amongst her peers as well as Ms (indistinct). So I've presented this research to New Zealand and next week I'm presenting this research to United States because it's an issue that we're all coming to deal with. It's not just the amount of people that will be coming into care. It's also a different culture of care that we're going to have to be implementing if we are to be successful in delivering quality service.

PN1896

Thank you for that description. Hopefully on your device you can still see all of the screens. One of those has Mr Ward in it and he's going to ask you some questions now.

CROSS-EXAMINATION BY MR WARD�� [1.57 PM]

PN1897

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

PN1898

Thank you. My name is Nigel Ward, Ms Gilchrist. I appear in these proceedings for the employer interests. I'll try not to keep you too long but you do present me with a very unique opportunity. I see in your statement at paragraph 5 that you used to teach the Certificate III in Aged Care. is that correct?‑‑‑Yes, so I taught vocational education with TAFE Queensland and I taught Certificate III in Individual Support and that covered aged care and disability, depending on what they needed me to do at the time.

PN1899

How long did you teach aged care Certificate III in Individual Support for?‑‑‑So approximately 18 months in TAFE - prior to that I was teaching for another RTO but it was community health services at a Cert II level.

***�� JADE GILCHRIST�� XXN MR WARD

PN1900

I sent you some or we had sent you earlier today some documents. Did you receive anything?‑‑‑Yes, I did.

PN1901

Thank you very much. One of them is - they're all documents related to the Certificate III course. I imagine you'd have some familiarity with them?‑‑‑Yes.

PN1902

I thought you would. I'm just going to describe three documents we provided: CHC33015, Certificate III in Individual Support. Commissioner, this document has been provided before but we'll rely on that. I then provided the document relevant to two modules in the Certificate III: one is HLTHPS006, Assist Clients with Medications. One is HLTHPS007, Administer and Monitor Medications. Do you have those in front of you, Ms Gilchrist?‑‑‑Yes, I do.

PN1903

If I ask you a question you can't answer, please just say you can't. I'm not going to ask you something you're not comfortable answering. Am I right, if I look at the first document, which is the Cert III in Individual Support - I'm correct, aren't I, that HLTHPS006 and HLTHPS007 are elective modules for the Certificate III in Individual Support. Is that correct?‑‑‑No, it is an elective for - the HLTHPS006 - that is an elective. So for an RTO they can either provide that as part of the package or depending on the person who's delivering the training, if they do not have a clinical background it can be an extra skill set that would be attached to the training package, which would be a voluntary thing to whether the student would like to do that.

PN1904

So - keep going, keep going?‑‑‑Okay, so with the HLTHPS007, that would be offered in a Cert IV level, so you would not be able to complete that - it's not an elective under a Cert III. I cannot see it here as a Cert III in the electives but you can probably have it in at your Cert IV level.

PN1905

Okay, so if I could just make sure I understands that: as you understand it, HLTHPS007 might be relevant to a certificate IV in aged care?‑‑‑That's correct.

PN1906

HLTHPS006 could form part of me doing my Cert III, is that correct?‑‑‑Yes, that's correct.

PN1907

It also could be done separately?‑‑‑That's correct.

PN1908

If I do it separately, what am I described as having when I've done it separately? Do I just have that competency module?‑‑‑Yes, so you'd be competent to assist with medications. That would be part of the role.

***�� JADE GILCHRIST�� XXN MR WARD

PN1909

In terms of doing the one element - let's say I was doing HLTHPS006 separately from a course perspective - how many hours would that normally involve?‑‑‑Well, if you go to the training package, off the top of my head now - please bear in mind I haven't worked in the industry for nearly four years - but it would be needing you to do - it's either 120 hours or 240. I'd have to have a look. Yes, I'll see if I can - - -

PN1910

Yes, it's 120 hours for the whole Certificate III, isn't it?‑‑‑For each module - so usual they will put them - so if you've got your - what they do, a practical placement, then for that time you would obviously mark off different competencies based on the assessment requirements of different units so for the electives some of them require practical placement to be able to achieve the assessment requirements whereas others may not. So it could be - like I said I need to go in and have a look to whether it's - I think it is 120 hours or it could be 240.

PN1911

Could I just understand - when you say it's 120 hours, are you saying the Certificate III itself is 120 hours or just doing one element is 120 hours?‑‑‑No, the whole practical placement would be 120 hours.

PN1912

Yes?‑‑‑I think it roughly equates to four weeks.

PN1913

Okay, and the - you could do HLTHPS006 in your 120-hour practical placement?‑‑‑If the RTO has included that in your training package, yes.

PN1914

Thank you. That's very helpful. That's clarified the confusion I had. Can I take you back to well, what is not your current job because you've got a new current job?‑‑‑Yes.

PN1915

But can I take you back to what your last job was. When you were the lifestyle and volunteer coordinator at CCHS, who did you report - - -?‑‑‑Yes.

PN1916

- - - who did you report into?‑‑‑Initially, when I started the role I would report to the care coordinator. When the care coordinator left it would be the director of nursing or the general manager, so depending on who was available, initially it would be the care coordinator.

PN1917

I take it the job had two elements. It had the lifestyle element and the volunteer element. Is that a reasonable way of describing it?‑‑‑Yes.

***�� JADE GILCHRIST�� XXN MR WARD

PN1918

If I could just do each one in turn. In terms of the lifestyle element, how many people were working underneath you?‑‑‑So, I had two staff, two paid staff.

PN1919

What roles were they in? Were they recreational officers?‑‑‑Yes. So, they were the recreational officer or activities officer, lifestyle advocate. It depends on the facility what they're called but yes.

PN1920

In relation to CCHS, did the people working for you have a Certificate IV? What qualification did they have?‑‑‑One of them had a Certificate IV.

PN1921

Yes?‑‑‑And the other staff member had a Certificate III with an Introduction to Leisure and Health skillset that I said that was a requirement for her to be accepted for the position, working towards a Cert IV in Leisure and Health. So, she was already enrolled and completing the Cert IV level when I left.

PN1922

In relation to the volunteer coordinator side, can you help me out. How many people worked for you in that side?‑‑‑So, as a volunteer coordinator, I had no staff but I had about 15 volunteers.

PN1923

We haven't heard any evidence to date on volunteers. What do volunteers do?‑‑‑Everything. Every (indistinct) therapy department will have a very heavy reliance on volunteers if they are able to have volunteers. So, it's very much a part of what we do, so unless there's a particular limitation because of the facility that you work in, we rely heavily on our volunteers to do anything. Whether it be one to one, pushing wheelchairs, helping with craft activities. They could be doing networking. Helping with logistics. Moving people from A to B. Helping with behaviour management. Helping with assisting people with food. Whatever it is that they're allowed to do according to the facility, whatever they're trained to do and whatever the volunteer is comfortable in doing.

PN1924

Who are the sort of people who volunteer?‑‑‑Well, it'll be a mixture. My volunteer base was mostly the elderly people. We would have a couple of volunteer positions that were related to Centrelink, so they'd have to work X amount of hours for their payment. So, I had a lot of students that would come through for placement, so do to their prac hours. So that would probably be - so our main volunteers were the elderly, people who have retired.

PN1925

I take it from what you've just told me that they could help with recreation, they could help with care, they could do almost anything they're capable of doing?‑‑‑Yes.

***�� JADE GILCHRIST�� XXN MR WARD

PN1926

Is having volunteers peculiar to CCHS or is it your understanding they're quite prevalent in the industry?‑‑‑No, I think it wouldn't matter where you worked in the lifestyle department, volunteers were extremely important to be able to do your job well and give good quality outcomes.

PN1927

Can I just take you to your first statement. I won't keep you very long, Ms Gilchrist, I promise you. Can I just take you to paragraph 16, I just want to clarify this. You say when you talk about the facility that it had 62 residential positions and I assume we're talking there about the residential aged care facility?‑‑‑No, it had a private hospital and it also had a residential care facility and it had a memory support unit, and what would have once been sort of the hostel department. So it was made up of about four different types of care services.

PN1928

When you say there's 62 residents, is that 62 aged care residents?‑‑‑That would be - 62 would - 12 from the hospital, so you'd probably have about 50 aged care residents and then 12 in the private hospital but we did have some long stay aged care residents in the hospital.

PN1929

And just can you explain to us why some of them would have been in the hospital?‑‑‑I think that was their choice. That was something that probably would go to my manager. I did ask the same question but apparently there was some people who perhaps were Veterans Affairs and were able to stay in the hospital, something to do with the funding. So that was something that was outside of my knowledge.

PN1930

No, that's fine. That's fine. At paragraph 16 when you say:

PN1931

CCHS employs approximately 100 staff.

PN1932

?‑‑‑Yes.

PN1933

Is that 100 staff for the whole of what you've just described?‑‑‑Yes, so that would be everyone from your admin staff, your catering staff, your maintenance, your - everybody. That would be everybody.

PN1934

Everybody. Including the private hospital?‑‑‑Yes.

***�� JADE GILCHRIST�� XXN MR WARD

PN1935

I take it when you played the role that you did of lifestyle and volunteer coordinator, you were doing it for the whole of the facility?‑‑‑Well, yes, we were. We were providing for the whole, so even though the hospital technically would not have come under the funding, we did accept them as part of that because you could hardly run activities and then if someone came from the hospital which was in the same building, we couldn't turn them away. So, we did basically cater to everybody who would be there.

PN1936

Thank you. Can I ask you to turn your mind to when an aged care resident arrives for the first time?‑‑‑Yes.

PN1937

I just wanted to clarify as difference people describe this a different way. My understanding is that there will be registered nurse who will engage with the family and the resident to prepare their - what we understand in these proceedings to be their care plan?‑‑‑Yes, that's correct.

PN1938

And am I right that separate to that, your team would have prepared a recreational activities plan for them as well?‑‑‑Yes, that's correct.

PN1939

What would that normally be called, Ms Gilchrist?‑‑‑Well, there was different ones depending on the facility that you go to. So, it could be The Key to Me, it could be a lifestyle care plan. My particular care plan was called Resident Goals, so I was looking at goals of the resident to keep active in whatever it is that they wanted to while they were in the facility. So, yes, so you do a - yes, so that was the name of the care plan.

PN1940

Was your care plan separate to the general care plan or did they become consolidated?‑‑‑They were separate.

PN1941

They were separate, okay. If your activity care plan affected the care of the resident, how did you sort that out with the registered nurse?‑‑‑So, what we would do is we have handovers, so that would - or you'd have - you'd communicate through verbally, so let's say we had an outing organised or an activity organised if the client wasn't going to be there, you know, the nurse would tell you that they're going to be away that day. They have a doctor's appointment. So, usually in the morning I would go to work, I'd go to see the RN on duty and I would let her know that this is what's happening today, and I need to know the health status of all the residents, because if we have someone who's had a stroke or some kind of event overnight we need to know that so we don't try and get them out for an activity and then they have an incident, and it is at that time it's up to them to notify us, and then that way we can avoid clashes.

***�� JADE GILCHRIST�� XXN MR WARD

PN1942

In terms of how you prepare activities for residents am I right in saying that you would have read or been inducted into the general care plan to understand their acuity and everything related to them?‑‑‑I would like to say yes, but on a lot of occasions no. So that was a little bit of a tricky point. In some facilities, in the ones that I worked at there was a little bit of a tension between the lifestyle team having accessed clinical documents, so it took a while to get over that, to explain, you know, we need to know what their, you know, illnesses or medications might be that can affect them in how we can support activities for them. So in a perfect world - - -

PN1943

Is there any reason for that tension?‑‑‑I think it's cultural, but in other places where - you know, so in other facilities that I've worked in we would have access to a database, and you would have - you would be able to see all the information that you needed. So again it depends on the facility, it depends on where they're at. When I started at Clifton Community Health Services it was all still paper-based, and there was a very big divide between the two departments. You know, in other facilities where it's computer-based then you can pull up a client and can read through the information and get an understanding of the client's needs before you meet them.

PN1944

So ordinarily it would be important for recreational staff to have a fairly good understanding of the general care plan for the resident?‑‑‑Absolutely. It is paramount, because you need to understand all of their needs, because, yes, that's going to direct you in how you're going to modify your activities so that they can be fully supported.

PN1945

And that might relate to their acuity, it might relate to their preferences, or a whole variety of things?‑‑‑A whole variety. I mean physical, emotional, cognitive, you know, knowing if someone's going to be triggered if something is done or said, you know, it's very complex.

PN1946

And you said earlier that you had two people working for you, one who had a Certificate IV, one who had a Certificate III and I think something else, and you accept (indistinct) on the basis she was going to get her Certificate IV or he was going to get his Certificate IV?‑‑‑Yes.

PN1947

Is it important for somebody in the recreational job to have a Certificate IV?‑‑‑It is vital, because without that there's not that understanding of why things are done the way they are done. So I think it is extremely important that they have that understanding.

PN1948

I will just keep you for a little moment longer if I can. I just want to make sure I understand a couple of parts of your evidence. Can I take you to paragraph 37?‑‑‑Yes.

***�� JADE GILCHRIST�� XXN MR WARD

PN1949

You say here, 'I am responsible for writing up care plans.' I take it that's the recreational care plan you and I talked about earlier?‑‑‑Yes, that's correct.

PN1950

On paragraph 43 you say, 'I'm not supervised in my work'?‑‑‑Yes.

PN1951

I don't mean this to be disparaging, but I assume that you mean by that that you're not directly supervised?‑‑‑No. So I - - -

PN1952

You still report to somebody?‑‑‑Yes. So I still report to the care coordinator usually if I have a concern or a query, but I don't - it's not like I report what I've done for the day. It's if I have a concern or a query I will go to them. If there's behaviour, unmet need or something or anything to do with implementing a new program I might discuss it with them, but I have a lot of autonomy in that position.

PN1953

You had a fair amount of what we call day to day autonomy - - -?‑‑‑Yes.

PN1954

- - - but if it was a sort of bigger item or had a broader implication you would go and talk to your manager or relevant people about that?‑‑‑Yes.

PN1955

Thank you, Ms Gilchrist, no further questions.

PN1956

COMMISSIONER O'NEILL: All right. Mr McKenna, did you want to shake your head. All right. Anything in re-examination, Mr Gibian.

RE-EXAMINATION BY MR GIBIAN�� [2.19 PM]

PN1957

MR GIBIAN: I think there were just two matters. Ms Gilchrist, can you hear me again?‑‑‑Yes.

PN1958

You were asked some questions at the start of the cross-examination about the Certificate III and two of the modules dealing with medication. So far as ATLCHES006 you describe that as an elective in the Certificate III individual support. I understood that correctly?‑‑‑Yes.

***�� JADE GILCHRIST�� RXN MR GIBIAN

PN1959

You later said in answer to another question that you might do that module if the RTO includes it in your training package. Maybe the term 'elective' - at whose election is it; that is can the student choose it or does it depend upon whether the RTO offers it as part of their package for the Certificate III?‑‑‑It would be up to the RTO to offer it. So in a package you have your core units, so they're the units that are not negotiable, you must do them, and then you have your elective units. Now, depending on the RTO, depending on the trainers they have available, they will populate those electives according to the training package, what can be subbed in as an elective. So for example when I was training students I would not deliver the assist with medication skillset, because I do not have clinical background, but if an RN, registered nurse, was able to deliver that, they had that certificate and they were working as a TAFE trainer, they may be able to offer that because they're able to mark those students off. So dependent on the trainer's skillset to what could be included. So for a lot of RTO's they will add that as a separate skillset, so not only does it make sense I think from a business point of view as a value add to, to get another, you know, paying customer for a skillset, but it also doesn't rely on the trainer to have that skill innately.

PN1960

And I think you were also asked whether you could do that unit, that is the assist clients with medication, separately from having done the Certificate III, and you agreed you could. What would ordinarily be involved in that in terms of the amount of study and/or practical training involved in doing the unit separately to a Certificate III?‑‑‑If you do the unit separately you still would be required to do the prac, so you'd have your practical assessment. So for example when we have facilities that we might get a trainer to come in they will do one day face to face and that's where they go through all the materials that they have to learn and to be able to be competent in, and then it would be up to the RN or someone who's on that facility to mark off all their third party reports to say that they've actually done the practical aspect of that assessment. But then it would be up to the trainer to come back, check that all the written work is complete, and then all the practical tasks have been complete as well and signed off by someone who's qualified to sign off on that, and that can - yes, so that can take 120 hours of work that would be required. So if they're already working in the industry then obviously it would be part of their normal daily duties, that they would then be supervised to give medication and marked off at the same time, but you can't do it without your practical placement. No one can get that certificate without the practical placement.

PN1961

All right. Thank you. The other thing that I just wanted to ask you to elaborate upon is you were asked about the qualifications that the recreation officers had who worked with you, and you said that the Certificate IV was vital, and then you said it was vital so they understood why things are done the way they are done. That's my recollection, or my note of what you said?‑‑‑Yes.

***�� JADE GILCHRIST�� RXN MR GIBIAN

PN1962

I just wanted to ask if you could explain that. What did you mean by 'why things are done the way they're done'?‑‑‑Okay. So we quite often in this industry will come across people who have been assigned the duties of being the resident lifestyle coordinator that have come from either a nursing background or an admin background, so they will get the badge of, say, tag you're it. One of the difficulties is that they may do things � so I'm going to give you an example. They might do let's � like, let's do painting - let's do finger painting for the people in the dementia wing because they can't use brushes properly or something like that, and you know, we have a lot of colouring in and a lot of these different things that are done, but for someone who has had training in, you know, the leisure and health services we'd have to say, well, we wouldn't do that, because it is not a dignified practice. So quite often you need to understand that, yes, finger painting is good and it's fun, but it's something that could be seen as childlike, so you need to be able to create activities that do not take dignity away from the client, and when you have someone come in who doesn't have a background or an understanding, they do all sorts of things. They seem to have this idea that these people, because they've got limited cognition or dementia, oh they're just like children. So they fall into the trap of offering childlike activities, and that's something that as in best practice we would not do, but if you don't have the qualifications and the training, you don't know that.

PN1963

Thank you. Those were the additional questions. Thank you, Ms Gilchrist.

PN1964

COMMISSIONER O'NEILL: Ms Gilchrist, thank you very much for your evidence this afternoon. You're now free to go?‑‑‑Thank you very much.

<THE WITNESS WITHDREW�� [2.26 PM]

PN1965

COMMISSIONER O'NEILL: Mr Gibian, is it Ms Peacock next or Ms Boxsell?

PN1966

MR GIBIAN: We were going to go to Ms Boxsell just in case we don't get through the other witnesses. As I indicated, Ms Peacock can be moved around a little bit more easily than some of the other witnesses.

PN1967

COMMISSIONER O'NEILL: All right.

PN1968

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

PN1969

MS BOXSELL: It's Kerrie Ann Boxsell, 61 Barranjoey Road, Ettalong Beach, NSW, 2257.

<KERRIE ANN BOXSELL, AFFIRMED�� [2.27 PM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [2.26 PM]

PN1970

COMMISSIONER O'NEILL: Your witness, Mr Gibian.

***�� KERRIE ANN BOXSELL�� XN MR GIBIAN

PN1971

MR GIBIAN: Thank you, Commissioner. Ms Boxsell, can you hear me adequately?‑‑‑Yes, I can.

PN1972

Can you just repeat your full name for the record?‑‑‑It's Kerrie Ann Boxsell.

PN1973

And you're care staff team leader for Evergreen Life Care in West Gosford?‑‑‑Yes, I am.

PN1974

You've made two statements for the purposes of these proceedings. The first is dated 31 March 2021. Do you have a copy of that with you?‑‑‑Yes, I do.

PN1975

It runs I think to nine pages and 73 paragraphs. Have you had an opportunity to read through that?‑‑‑Yes, I have.

PN1976

Is it true and correct to the best of your recollection?‑‑‑Yes. The only thing I've noticed is my middle name actually is spelt wrong. It's got an 'e' on it. It shouldn't have an 'e' on it.

PN1977

It's Kerrie Ann � A‑n‑n � Boxsell?‑‑‑Yes.

PN1978

With that correction, is the statement true and correct to the best of your recollection?‑‑‑Yes.

PN1979

That's the first statement upon which we rely of this witness, Commissioner. It's document 192, commencing at page 10919 in the digital court book. You should also I think have a statement headed, 'Reply witness statement of Kerrie Ann - again with an 'e' erroneously - Boxsell dated 19 April 2022. Do you have a copy of that?‑‑‑Yes, I do.

PN1980

It runs to 48 paragraphs over six pages. Have you also had an opportunity to read through that document?‑‑‑Yes, I have.

PN1981

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

PN1982

Thank you, Ms Boxsell. That document is document 193 in the digital court book commencing at page 10928 for the record, and we rely upon that statement as part of the evidence. Ms Boxsell, there was just one matter that I wanted you to clarify. Can I ask you to turn to your first statement?‑‑‑Yes.

***�� KERRIE ANN BOXSELL�� XN MR GIBIAN

PN1983

On page 2, towards the bottom of page 2 at paragraph 17(a), you indicate that your duties generally include � and you see a little (a) in paragraph 17 � you say 'leading a wing of nurses to exercise care for residents.' Can you see that?‑‑‑Yes.

PN1984

I just wanted to ask you to explain what you meant by 'leading a wing of nurses'?‑‑‑The nurses is as in care staff nurses. There isn't a team leader. We have our care staff under us, and that's where we look after that wing under the supervision of the RNs.

PN1985

So in leading the wing of nurses, you're referring to leading the care staff, is that - - -?‑‑‑Yes.

PN1986

Thank you, Ms Boxsell. Hopefully on the screen in front of you you'll be able to see a number of boxes. One of those has Mr Ward in it and he's going to ask you some questions now?‑‑‑Yes.

CROSS-EXAMINATION BY MR WARD�� [2.30 PM]

PN1987

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

PN1988

Thank you. Ms Boxsell, my name is Nigel Ward. I appear in these proceedings on behalf the employer interests. I'll try not to keep you too long. Have you got your statement in front of you?‑‑‑Yes, I have. Which one?

PN1989

I'm just going to deal with the first one, if I can?‑‑‑Yes.

PN1990

You describe your role as a team leader. How many people do you have in your team?‑‑‑Mostly it's either two to three, depending which area we work in.

PN1991

What do you mean by that?‑‑‑If you're in the high care section, it's three people under you. If you work out in the other areas, it's two people under you.

PN1992

When you say, 'the high care section', is that a secure dementia area, or what is that?‑‑‑No. That's our high care for people that are immobile and need, like, to assist � they need more assistance.

PN1993

So it's not necessarily about their acuity, it might be about whether or not they're ambulant and things like that?‑‑‑Yes.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN1994

Do the people who work for you, do they all hold Certificate IIIs in Individual Support (Ageing) or some related field?‑‑‑Yes.

PN1995

Is that a requirement from your employer, Evergreen?‑‑‑Yes, it is.

PN1996

If I take you to paragraph 4, can I ask you to reflect on, first of all, 4(b), Certificate in Advanced Dementia Care in 2014. Can you just explain to us what that certificate actually is?‑‑‑I did it through TAFE and it was just going through a lot of � a bit more broader in doing dementia advanced, so it was a longer course. It went weekly. I can't remember now it was so far back � it was a fair � like, two hours after work we did it. It was just learning more advanced dementia on � sorry, I've got to remember now � on the people with dementia, why they have dementia, how to deal with it, and more strategies in how to look after them in an aged care setting.

PN1997

You did that before you did your Certificate IV, is that right?‑‑‑Yes.

PN1998

Do you have a copy of that certificate?‑‑‑Not with me, I don't, but I do at home.

PN1999

Commissioner, I am going to call for that if that's possible.

PN2000

COMMISSIONER O'NEILL: Any problem, Mr Gibian?

PN2001

MR GIBIAN: No, only the practical one of obtaining it, but we will communicate with Ms Boxsell in relation to that.

PN2002

MR WARD: Ms Boxsell, that just means I've asked you to provide a copy of it. Don't get too distressed about that. If you can't find it you will have to let us know. Can I then take you to the one that's in 4(d), Certificate in Aged Care Worker Skills. I haven't heard of that before, what's that?‑‑‑That was more like a buddy - buddy skills. So when we had new staff it was just - it's just telling you - it was like a basic leadership course. Yes. Just so when you've got new staff coming in how to help them, how to communicate with them, you know, doing paperwork and stuff like that.

PN2003

Again, Commissioner, if I can call for that. And then you've got - - -

PN2004

MR GIBIAN: Sorry, which one was that, can I just clarify.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2005

MR WARD: Sorry, that's 4(d).

PN2006

MR GIBIAN: Thank you.

PN2007

MR WARD: There is then one which is 4(f), Certificate in Palliative Care?‑‑‑Yes.

PN2008

Can you just describe that for us as well?‑‑‑That was just a day course, a quick day course that we had. I got chosen to do that one because I'd been there for a while and they chose me to go and do that course. I went with RNs, the ENs and some other staff members they put in, so we could learn and do a bit more about palliative to look after people at the end of life and when their palliative starts their journey along.

PN2009

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

PN2010

I call for that. Then you've got one which is 4(h), Certificate in Infection Control. What did that involve?‑‑‑That was - that was a TAFE course as well. That was - so when COVID come on I decided to do - to get more knowledge for COVID and infection. I did that one online because I couldn't go to TAFE to do it. It was just going through all procedures of infection, donning and docking off, spills, spill kits, and how to deal - how to deal with infection control.

PN2011

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

PN2012

I call for that as well. If I can then take you to paragraph 5, you say:

PN2013

It is mandatory to have a Certificate IV in aged care and first aid certificate for my care staff of Evergreen.

PN2014

I am just going to break those apart. You're talking there about two separate things, aren't you?‑‑‑Yes.

PN2015

Is the first aid certificate a St John's Ambulance certificate?‑‑‑Yes, or I've done it at TAFE before, I've done it through other training, private training companies, as long as you have a first aid certificate.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2016

You say there it's mandatory to have a Certificate IV for your job?‑‑‑I don't think it is now; it was. I have mine updated every year, so I'm not really quite sure if it is mandatory or not any more, because I do mine for outside of work anyhow and I have it, so - - -

PN2017

If you think you can't answer this please just let me know?‑‑‑Yes.

PN2018

When you started the job and it was mandatory to have a Certificate IV did you believe it was necessary to do your job to have a Certificate IV?‑‑‑When I started I did care staff Certificate III work, and then as I got my skills up I decided to go and do my Cert IV.

PN2019

What I'm asking is could you be the team leader without a Cert IV?‑‑‑In those days, no.

PN2020

I am going to struggle with that question. That's fine. Can I take you to what Mr Gibian took you to in 17(a). I think you've already helped me with this, but I just want to confirm. You say there leading a wing of nurses?‑‑‑Yes.

PN2021

I take it those are people who have their Certificate III?‑‑‑Yes, and some are Certificate IVs.

PN2022

How many have Certificate III versus Certificate IV?‑‑‑It depends on who's done their Cert IVs and who's done their Cert III and how we're rostered on for the day.

PN2023

So is it their choice to do a Cert IV or are they part of turning up when they were required to have a Cert IV?‑‑‑We have to have a Cert IV on each wing, although we are allowed now to have Cert IIIs with their medical. That's only just coming in the last three years I think it is. You're allowed to have Cert III with your medical, with your medication certificate, but when I did my Cert IV you could only be a team leader if you had Cert IV.

PN2024

Was that to ensure - we found out earlier today that there is a Cert IV competency called administer and monitor medications - is that why they wanted you to have a Cert IV so you did that?‑‑‑Yes.

PN2025

Thank you very much. Can I take you to page 3 if I could, and there's two comments at page 3 about medications. At the very top of the page there's a reference to giving out medications to residents, and then at paragraph 27 you say:

PN2026

Once residents are ready for the day I begin assisting in medication.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2027

Can I just understand your process compared to other people's processes. Am I correct that the RN will deal with the schedule 8 medications?‑‑‑Yes.

PN2028

Do you ever attend along with the registered nurse to validate or to co-sign something being taken, or do they do that themselves?‑‑‑No, we help them if there's only one RN on duty. Sometimes we have two RNs or an ER - an EN, sorry. It just depends on the shift and the availability of our RN.

PN2029

Okay. So if there's two RNs on duty they might take their (indistinct) themselves, is that correct?‑‑‑Yes.

PN2030

If there's an RN and an EN they might take care of it, but if there's only one RN you might go along with them to verify what they're doing?‑‑‑Yes.

PN2031

And I take it that the RN doesn't get involved in schedule 4 medication?‑‑‑I've got to think what schedule 4 is. They do the PRNs. We're not allowed to do anything that's PRN, they do them, but if it's Webster packed we can do it.

PN2032

So bear with me, we will just go through that slowly. So if somebody's suffering from pain and you need to give them some pain relief as a one off that would normally be a PRN, that goes to the registered nurse, does it?‑‑‑It depends, if it's a Panadol we can do it, but if it's anything over that, yes, we have to call the RNs and get them to administer it.

PN2033

So if it's Panadol you have the authority to decide they can have the Panadol?‑‑‑No, we have to call the RN to get permission to give it to them.

PN2034

Okay. And then you can administer the Panadol?‑‑‑Yes.

PN2035

So schedule 4 drugs are described as prescribed restricted substances, and I think we're largely talking about things not opiates, none of those sort of top shelf drugs. Does that ring a bell now?‑‑‑You see it's very hard because we do the Webster packs and you don't know what everything that's - what they're called and what they're doing, so I'm very sorry about that.

PN2036

No, that's fine. I don't want to be unfair to you (indistinct) answer. So the Webster packs are they kept in a locked cupboard?‑‑‑Yes.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2037

And do you have the keys to the cupboard or the RN?‑‑‑We have the keys to our own wing.

PN2038

Your wing?‑‑‑Yes.

PN2039

So you will have a cupboard on your wing for your residents?‑‑‑Yes.

PN2040

Just bear with me I'm going to walk through what I think might happen. Tell me if I'm right or wrong. When you're doing a medications round you would go to that cupboard, you'd unlock it. There will be Webster packs prepacked for the residents on that wing?‑‑‑Yes.

PN2041

You will get them out, put them I assume on a medications trolley?‑‑‑Yes.

PN2042

There might be other things like eye drops and things like that as well?‑‑‑Yes.

PN2043

And you will then obviously start by going to the first resident on your list to administer the medications. Am I right so far?‑‑‑Yes.

PN2044

When you get to the residents, I am right that you will check that what is described as the medication on the Webster‑pak you'll check that against something to make sure it's the right drug?‑‑‑Yes, we check it against the doctor's prescribed order sheet, and we've got to make sure that it's dated, signed, that it's not out of date, and that they don't have any allergies to that type of medication.

PN2045

How would you make a decision if they had an allergy?‑‑‑On a simple medication you could, but on a big medication, that would be the doctor.

PN2046

That would be the doctor?‑‑‑Yes.

PN2047

Do you also � we've heard a lot of people talk about physically checking the shape of the tablet against like a picture chart - do you do that?‑‑‑Yes.

PN2048

How the medication is to be administered, is that written on the Webster‑pak as well?‑‑‑No. It's written on � we use an iPad with our medication charts in there, and on the front of it we have a little description for the residents and we have to read that so it will tell you if it needs to be crushed, and often the doctor will for us write, 'Please crush this medication.'

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2049

So you'll read that, and if you have to crush it, it'll be put in a custard or something like that?‑‑‑Yes.

PN2050

I take it that you either hand the medication to the resident, you might feed it to them on a spoon if it's in a custard?‑‑‑Yes.

PN2051

And you observe whether or not they take it?‑‑‑Yes.

PN2052

And then I take it that you would, on your iPad, confirm that they've taken it?‑‑‑Yes.

PN2053

If you have a troublesome resident who's not keen on taking their medication today, you keep trying?‑‑‑Yes, of course you keep trying.

PN2054

If they ultimately refuse, you'd write the fact that they refused the medication on the iPad?‑‑‑Yes, and you let the RNs know that they haven't taken their medication, and also we document it in the progress notes as well so it's in our iCare system.

PN2055

If you notice something wrong, that is, this tablet doesn't look the right shape compared to the picture chart, who do you go to?‑‑‑We go to the RNs.

PN2056

Your progress charts � so you're writing up obviously have they been to the toilet, have I showered them � you do all those things?‑‑‑Yes.

PN2057

And you record that in your progress charts when you're on the shift?‑‑‑Yes.

PN2058

Does that go on to the iPad as well, does it?‑‑‑No. The iPad's only � and it's called MedMobile, and it has all of our medications on it. You can use the iPad for iCare and doing progress notes, but it's not really user‑friendly. It's easier to go and get the computer to type on a keyboard.

PN2059

That's at the nurses station or something like that, is it?‑‑‑Yes.

PN2060

Can I take you to paragraph 31? You say in paragraph 31:

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2061

After medication rounds are complete I usually complete general tasks, helping other care staff, attending to buzzers, assisting with toileting, ordering stock and ordering medications.

PN2062

What sort of stock do you order?‑‑‑We order plastic bags, our garbage bags, tissues, toilet paper. We do all that for our stock cupboard.

PN2063

Yes?‑‑‑Laundry bags, all of that type of stuff, alginate bags. We send that off to the cleaners, if we've run out, and do things like that, yes.

PN2064

Is that part of your role as team leader?‑‑‑We just do it, whoever's got time. It's just part of the team.

PN2065

So that's not - - -?‑‑‑(Indistinct) job.

PN2066

That's not a registered nurse role; that's your role?‑‑‑Yes.

PN2067

It also says, 'ordering medication.' Tell me what that means?‑‑‑That's � so we go through our trolleys, see if we've run out of Movicol, Panadol liquid, eye drops that are not in monthly bottles. What else do we have there? Creams, any creams that they need, any puffers, and things like that, and also we go through our PRN Webster‑paks to see if they're out of date and need restocking.

PN2068

Where do you go to order those medications?‑‑‑We go down to the RN's office.

PN2069

And so you ask the RN to order it, or do you order it?‑‑‑No, we put it on a sheet.

PN2070

Where do you actually get the order from?‑‑‑We email it to the pharmacy.

PN2071

Do you email it or does the RN?‑‑‑It depends on how urgent we need the stock. If it's urgently and we need it for that afternoon, we'll let the RNs know and we'll put it through. If it's not urgent, they'll put it through for us.

PN2072

Can I just take you briefly to 33?‑‑‑Yes.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2073

You talk there about some RN duties, and the last one is, 'Assessing aggressive behaviour.' What's the role of the RN in doing that assessment?‑‑‑That's just coming in if we can't calm them down and we need some extra help. We might need an extra pair of hands. Sometimes when we have especially two in the room � we have partners, husband and wives � sometimes we need the extra hand to look after the partner so we can shower them without them coming in and interfering, or we need � you know, we need them to assess them to see if we need medication, to see if it's pain, to see if it's stuff like that.

PN2074

At paragraph 34 you say:

PN2075

As a team leader I also have to attend to residents who have falls. I've learnt the procedure of how to attend to falls through my aged care training and also the procedures in place at Evergreen.

PN2076

When you refer to your 'aged care training', are you referring to your Cert III and Cert IVs?‑‑‑No. We have mandatory training that we do through our physio once a year, and we also have online training that we need to do as well every year.

PN2077

How long's the online training for falls?‑‑‑It depends on what system we're using.

PN2078

Help me out?‑‑‑It averages about 45 minutes.

PN2079

Right?‑‑‑We've changed a couple of times with our providers, so depending on which one it is it's quite different.

PN2080

When you say it takes 45 minutes, is that online training teaching you the procedure that Evergreen use?‑‑‑Yes.

PN2081

Okay?‑‑‑Not exactly what it's using, but it's for all aged care. It's not just our training. It's the one that all aged care can use.

PN2082

So it's generic training that could be used in aged care?‑‑‑Yes.

PN2083

You also say here, 'And also the procedure in place at Evergreen.' I take it Evergreen have a falls procedure?‑‑‑Yes, we have policies and procedures.

PN2084

You're inducted into those?‑‑‑Sorry, what do you mean by inducted into it?

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2085

You're taught about those, you're explained what they mean and how to use those procedures?‑‑‑Yes. Yes, we do that more when we do our training with our physio.

PN2086

Just a minute. If I take you to 38, you say:

PN2087

As a team leader I also conduct medication audits once a week to ensure each resident has the correct medication for the upcoming week.

PN2088

Can you explain to me � it sounds like a pretty serious process � what do you mean by 'audit'?‑‑‑When the pharmacist brings over our Webster‑paks we get them, we get our MedMobile, and we get the doctor's prescribed order sheet, and we have to check the three off to make sure that our Webster‑paks are correct for the next week.

PN2089

So if I was one of your residents, you need to make sure that you've got the stock for me in the Webster‑paks for the coming seven days?‑‑‑Yes. Yes, and that a medication hadn't been ceased that the pharmacist could have already packed it. So then I have to go down to the RN and say this doesn't match, can you come and put a C sticker on it for me. And the same as what you were saying with the different tablets. One lady was getting a brown, like an oval tablet. In the new one it was a white, round tablet, so it didn't match the picture. So I had to go down and get the RN to confirm if it was the same tablet or not.

PN2090

You've done your check, something is not completely in place and we go down and talk to the RN?‑‑‑Yes.

PN2091

I want to take you back to the falls procedure?‑‑‑Yes.

PN2092

Does the falls procedure require you to involve the registered nurse?‑‑‑You mean when a resident has a fall?

PN2093

Yes?‑‑‑We hit the, 'assist', button. We make them comfortable as we can, depending on how they've fallen. We sit with them till the RN turns up and then the RN will do head-to-toe assessment on them. They'll do their obs. The RNs will do the eyes - I can't think of what that's called at the moment - the neuro obs and then we work out how we can safely get them up off the floor using the sling lifter.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2094

If the fall is of such a seriousness that the person has to go to hospital, does the RN organise that?‑‑‑Yes and someone stays with them until the ambulance turns up.

PN2095

Okay, and that could be you or it could be the RN?‑‑‑Yes, or it could be the care staff.

PN2096

Okay, right?‑‑‑Yes.

PN2097

I take it the RN will decide, given the nature of the fall, who has to stay with them?‑‑‑We usually work out where we're up to with our day. Like if it's in the middle of breakfast, or it's the middle of the night and there's not as many staff, then yes, we just work out where we're up to and if someone is in doing something that has to go back and that resident is on the toilet or something, we work out - yes, we sort of work out who will stay - - -

PN2098

How to double?‑‑‑Yes.

PN2099

Okay. Can I just take you to paragraph 40? You say that cleaning has become a major part of your job. Does Evergreen employ dedicated cleaners?‑‑‑Yes, we do.

PN2100

How are they organised?‑‑‑They're in the team with a team leader as well. They go and mainly clean the room - like, do the mopping and the toilet cleaning, the bathroom cleaning, the dusting, the vacuuming and the big details of the room. When someone moves out and someone comes back in they do a big detailing of the rooms.

PN2101

In terms of things like stripping the bed, you would still do that, your team would still do that?‑‑‑Yes.

PN2102

If I can take you to paragraph 50, you say Evergreen is one of the aged care centres in Gosford that trains the local aged care TAFE students where you get approximately five to six students at a time. This depends on how many are studying the course at a time. Is that because Evergreen have a relationship with the TAFE?‑‑‑I can't answer that because I don't do that. But since I've been there, over the 11 years, yes, we have always had trainees come in and it's not just TAFE but TAFE is our main one. I did my training there 11 years ago and I wasn't with TAFE.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2103

You were with a registered training organisation, a private one?‑‑‑Yes, I went through ET Australia.

PN2104

Okay, okay?‑‑‑Yes.

PN2105

I take it when you say they spend time with you, that's their 120-hour practical part of their Cert III, is it?‑‑‑Yes.

PN2106

If I could just take you to 65, paragraph 65 - help me out. I know I should know this: what's a basis team?‑‑‑I can't think exactly what the wording is but the basis team is the team that we can call up when - the specialists that deal with behaviours. It's actually a behaviour team. That's what the B is for. They will come in and help us and assess that resident and give us strategies on how to deal with this resident, looking at their backgrounds, what medication they're on, yes, and just helping out, maybe looking at pain, looking at their lifestyles and just helping us when we feel that we have got to that stage, we just don't know where to go to.

PN2107

That's fine. I take it that - I think you say there - I take it that the RN and possibly doctors are talking about calling in the basis team, are they?‑‑‑Yes, we've just got to make sure we document it so when they come in they've got the all documentation down because if they walk in and there's no documentation, as it's said if it's not documented, it's not done.

PN2108

I believe you. You talk in that paragraph a little bit about activities like pet therapy and the men's shed, which I'm sure would be good for me. Do you have a recreational officer?‑‑‑Yes, we do.

PN2109

So is the recreational officer's job to organise, primarily organise diversional therapy and activities?‑‑‑Yes, as in diversional - what do you mean by diversional?

PN2110

Well, you organise pet therapy and activities - - -?‑‑‑No, no.

PN2111

That's their job, is it?‑‑‑Yes.

PN2112

Okay?‑‑‑We've got a team leader in activities that does all that.

PN2113

Do you know if they have a Cert IV?‑‑‑Yes, she does.

PN2114

Thank you very much, Ms Boxsell, and I hope you have a lovely weekend. No further questions?‑‑‑Thank you.

***�� KERRIE ANN BOXSELL�� XXN MR WARD

PN2115

COMMISSIONER O'NEILL: Mr McKenna? All right, Mr Gibian, anything in re-examination?

PN2116

MR GIBIAN: Just a couple of matters.

RE-EXAMINATION BY MR GIBIAN�� [3.00 PM]

PN2117

MR GIBIAN: Ms Boxsell, you can hear me again, can you?‑‑‑Yes, I can.

PN2118

There were just a few things: you were asked some questions about the medication processes including what happens if you have a resident who is refusing to take their medication and I think you indicated you keep trying. I just wanted to ask if you could explain what types of techniques you use in that kind of situation to try and get the residents to take their medications?‑‑‑We can get another staff member to come along and talk to them and try to - depending on why they're refusing is big issue. You've got to try to work out why they're refusing and then calm them down, give them re-assurance that it's okay; maybe take them to somewhere quieter where there's no distractions, take them back to their room where they're familiar with their - with what's in the room that might settle them down a bit. Like I said, we get the RNs to come and help us and work out why this person isn't having - or whether it's because they're got a sore mouth or whether they just don't want it for today, you know? Then of course then if they keep doing it goes on to the doctors and the doctor has to come and review them as to why they're not taking their medications.

PN2119

You were then asked some questions about aggressive behaviours and I think you said, look, first you try and calm them down and if that's unsuccessful you might need to involve others. Again, I just wanted to ask you if you were able to describe some of the techniques you use to try and calm a resident down if they're aggressive or agitated in some way?‑‑‑Like I said, it depends - every resident is different so you've got to look at them, you've got to know your resident and look at them in their own way. We've sung to them - I know we can't do so much now and it's harder with masks and everything on but we try to sing to them. If we know what their family's names are, their kids, we talk about their kids. They might have something in their room, a photo that we can give to them, put music - put music on to calm them down. Then if that doesn't work, well, we leave them. If they've gone too far we have to leave them and then come back when they've settled down and try again.

***�� KERRIE ANN BOXSELL�� RXN MR GIBIAN

PN2120

Thank you. The last thing was you were asked about the basis team. I think you indicated it's the RN would - in consultation they'd call in the basis team and you referred to having to prepare the documentation for the basis team. What documentation were you referring to?‑‑‑We do behaviour charts that we fill in their behaviour so we know what their behaviour was, how long it went for, if we knew any triggers that led them to start this behaviour. Then we have to put our interventions in and what we did to de-escalate their behaviours.

PN2121

Thank you. Those were the additional questions, thank you, Ms Boxsell.

PN2122

COMMISSIONER O'NEILL: Ms Boxsell, thank you very much for your evidence this afternoon. You are now free to go. Thank you?‑‑‑Thank you so much.

PN2123

All right. Look, I'm going to need to just take a short break. I'm comfortable sitting through till 4.30 or 4.45 if we need to, to get through at least the three witnesses. Perhaps we might not get to Ms Peacock this afternoon but I think you've anticipated that. All right - - -?‑‑‑Do I need to - sorry, do I need to log off anything or do I just go?

PN2124

I think you can just leave it, Ms Boxsell.

PN2125

MR GIBIAN: I think you just leave it for the moment, yes?‑‑‑Okay, thank you.

<THE WITNESS WITHDREW�� [3.05 PM]

PN2126

COMMISSIONER O'NEILL: All right. We will resume at just after 3.10.

PN2127

MR GIBIAN: Thank you.

SHORT ADJOURNMENT�� [3.05 PM]

RESUMED�� [3.10 PM]

PN2128

MR GIBIAN: Apologies, I was struggling to turn the camera on again.

PN2129

COMMISSIONER O'NEILL: No trouble. Is Ms Gauci - - -

PN2130

MR GIBIAN: I understand so.

PN2131

COMMISSIONER O'NEILL: Good afternoon, Ms Gauci.

***�� KERRIE ANN BOXSELL�� RXN MR GIBIAN

PN2132

MS GAUCI: Hi.

PN2133

COMMISSIONER O'NEILL: I'm O'Neill C. You can hear me all right?

PN2134

MS GAUCI: Yes, thanks.

PN2135

COMMISSIONER O'NEILL: All right, terrific. Mr Gibian.

PN2136

MR GIBIAN: Thank you. Maybe the affirmation - - -

PN2137

COMMISSIONER O'NEILL: I'm sorry. My mistake. Ms Gauci, I should have said my Associate is just going to have you take the affirmation.

PN2138

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

PN2139

MS GAUCI: Fiona Kathleen Gauci, Uniting Edinglassie Emu Plains, 1-3 Emerald Street, Emu Plains.

<FIONA KATHLEEN GAUCI, AFFIRMED�� [3.12 PM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [3.12 PM]

PN2140

COMMISSIONER O'NEILL: Now over to you, Mr Gibian.

PN2141

MR GIBIAN: Thank you, Commissioner. Thank you, Ms Gauci. I'm Mark Gibian and I don't think we have actually spoken but I'm appearing for the HSU. Can I just ask you to repeat your full name for the record?‑‑‑Fiona Kathleen Gauci.

PN2142

And you're an administration officer for Uniting Aged Care?‑‑‑I was. I've changed roles since I gave the first statement.

PN2143

All right. What's your role now?‑‑‑I'm a Leisure and Wellness Coordinator.

PN2144

When did that change occur?‑‑‑It was approximately May/June last year.

***�� FIONA KATHLEEN GAUCI�� XN MR GIBIAN

PN2145

May/June 2021?‑‑‑That's correct.

PN2146

Now, you've made two statements for the purpose of this proceeding. Do you have copies of those with you?‑‑‑Yes.

PN2147

The first of those was dated 29 March 2021 and runs to some 78 paragraphs over nine pages. Have you had an opportunity to read that statement through?‑‑‑Yes.

PN2148

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

PN2149

So, that's the first statement, Commissioner, that we rely upon. Sorry, it's document 169 in the electronic court book, commencing at 10520. The second statement is headed, 'Reply witness statement of Fiona Kathleen Gauci.' You have a copy of that as well?‑‑‑Yes.

PN2150

Have you also had an opportunity to read through that statement?‑‑‑Yes.

PN2151

I'm sorry, it's dated 19 March 2022. Is it also true and correct to the best of your knowledge and recollection?‑‑‑Yes.

PN2152

That's the second statement of this witness, Commissioner, that we rely upon and seek to be part of the evidence. It's document 170 commencing at page 10529 of the digital court book. Thank you, Ms Gauci. Hopefully in front of you you'll see on the screen there will be a number of boxes. One of those has Mr Ward in it. He's appearing for some of the employer interests in the proceedings and he's going to ask you some questions now.

CROSS-EXAMINATION BY MR WARD�� [3.15 PM]

PN2153

MR WARD: Can you hear me now?‑‑‑Yes.

PN2154

Thank you, Ms Gauci. My name is Nigel Ward and as Mr Gibian said I appear in these proceedings for the employer interests, or at least some of them. I'll try not to keep you too long. I appreciate it's Friday afternoon. Can I just understand your role? I struggled a little bit to understand your role in the organisation. Am I right in saying that you started as an assistant in nursing?‑‑‑Yes.

PN2155

And you then moved to the administration role?‑‑‑Correct.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2156

Am I right in saying that the majority of your evidence, at least your first statement, relates to when you were in the administration role?‑‑‑Correct.

PN2157

And more recently you've done a career move and you've moved into being a leisure and wellness coordinator?‑‑‑Correct.

PN2158

I might start at the back end and work my way back down. Are you qualified � do you have a Certificate IV in Leisure or anything like that?‑‑‑Yes, so Leisure and Health.

PN2159

When did you get that?‑‑‑When I applied for the role, I went through TAFE and got a Certificate in Leisure and Health.

PN2160

Were you studying that or was there an element of recognition of prior learning involved in that?‑‑‑No, I was studying that. It took a year.

PN2161

So this was something you were aiming to get into?‑‑‑Yes. Yes, so we went into the new homemaker model, and this position came up. When I applied for it, I applied to do a Cert IV in Leisure and Health.

PN2162

I understand. In your new role as leisure and wellness coordinator, do you have anybody working for you?‑‑‑Do I have anyone working for me, sorry?

PN2163

Yes. Do you have a team or is it just you?‑‑‑Yes. Well, I'm on my own, but I am in charge of running certain things with other people. I supervise them in what they do.

PN2164

Can you just explain what you mean by that?‑‑‑So we're in the new homemaker model. Part of that is we have homemakers who run households, and my job from the leisure and wellness aspect is to make sure that what they're doing is what they should be doing, and I support them and mentor them.

PN2165

Your job is to design and the leisure and wellness activities and program?‑‑‑We don't actually do that anymore in the new homemaker model.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2166

Tell me what you do do?‑‑‑So what I do is I make sure that their paperwork is all up to date, what they should be doing, whether they're engaging properly with the residents, if they need more support or supplies. Anything like that, I will source that for them. I will source volunteers and mentor volunteers, onboard volunteers to make sure they've got that extra help as well. Any technical issues, I will help them with that. So anything to do with IT and getting on the computers and paperwork sort of stuff, I will support them in that as well.

PN2167

I'll come back to that at the end, if I can. Just bear with me. Can I take you back to your administration role? Could we just do that if we could, please?‑‑‑Yes.

PN2168

Did you have anybody working for you in that role?‑‑‑Not really, no.

PN2169

So again, it was you?‑‑‑Yes.

PN2170

Who did you work for in that role? Who did you report to?‑‑‑My line manager was the manager of the facility, the facility manager.

PN2171

Emu Plains, the facility at Emu Plains, could you just describe it for us; how many residents and how it's set up?‑‑‑Yes. So we've just redeveloped our site, so we've changed it a little bit. So now we are a facility with five households, and in each household there are 20 residents.

PN2172

When you say 'redevelop', you mean physically building work redevelop?‑‑‑Yes. Yes, we knocked down the old building and redeveloped it and built a brand new building.

PN2173

Was it a traditional aged care residential facility before?‑‑‑Yes.

PN2174

And now it's this new model?‑‑‑Yes.

PN2175

If I looked at it before, would it look like a hospital; would it physically look � was it one building?‑‑‑Well, it was built in the 80s, so not essentially so, but let's just say it's very, very modern and looks a lot bigger now.

PN2176

When you say there's five houses, are they literally five houses, or is that just the language you use to sort of describe the (indistinct) - - -?‑‑‑That's the language we use.

PN2177

So it's still in one building?‑‑‑Yes. So there's a ground level with one household, and the second level has two households � the first level, sorry, has two households, and then the second level has two households.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2178

I just want to, if I can, take you to paragraph 28?‑‑‑Is this in the first statement?

PN2179

Yes. Yes, I'm only going to take you to one part of your second statement, so we'll just stay with the first. You say in paragraph 28:

PN2180

In about 2020 I was required to complete medication training.

PN2181

I'm just going to pause there. This is while you were an administration person, is it?‑‑‑Yes.

PN2182

And without embarrassing anybody, can you explain why you were required to do that as an administration person?‑‑‑I think the wording is probably incorrect in that, like 'required.' Myself and my work colleague took medication training because we were always short, and so sometimes our manager would ask us to go and make beds, go and feed residents, and at times because they were short with medication, then we would be able to give medication if required as well.

PN2183

So you were helping out?‑‑‑Yes.

PN2184

I take it that when you did your training to be an assistant in nursing that that didn't cover that?‑‑‑No. You actually have to have separate training for medication.

PN2185

Do you recall what the training package is called that you did?‑‑‑No, I can't recall.

PN2186

Did you get a certificate for it at the end?‑‑‑Yes.

PN2187

Do you still have that?‑‑‑It would be on my � I put all my certificates in my work file, so it would be somewhere in there. Every year you have to redo that as well; not the whole certificate, but you have to be re‑evaluated to make sure you're not losing your skills as well. So I'm actually due to be re‑evaluated again.

PN2188

Commissioner, I'm going to call for that. Ms Gauci, don't stress about what that means. It just means I'm asking you to provide a copy of that certificate to the HSU, who are going to provide it to the Commission and me, that's all?‑‑‑Okay.

PN2189

COMMISSIONER O'NEILL: Any problem with that, Mr Gibian?

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2190

MR GIBIAN: Not that I'm aware of. We'll endeavour to communicate with Ms Gauci after she's finished her evidence.

PN2191

COMMISSIONER O'NEILL: All right.

PN2192

MR WARD: Thank you. You say that when you did that certificate the training occurred over a three‑week period. Does that mean it was 15 days of training, or do you mean - - -?‑‑‑No, it was three days, but it was over � so I did two days back‑to‑back and then there was a gap, and then there was the finishing day. But we had take home assessments as well during that time.

PN2193

Do you recall whether or not that was done with a registered training organisation?‑‑‑It was through Uniting.

PN2194

So, it was through the employer?‑‑‑Yes.

PN2195

Does Uniting have its own registered training organisation or was it just something in-house?‑‑‑No, they - I'm pretty sure they do. I couldn't tell you exactly - - -

PN2196

No, that's all right?‑‑‑I'm not going to say - yes.

PN2197

You had to do some practical with that as well?‑‑‑Yes.

PN2198

How many hours practical were you required to do?‑‑‑I can't recall. What ended up happening, so you do the two days back to back, then you do a third day where you hand in all your assessments and you do, like, practice training. Then after that you do practical in your facility supervised and then an assessor from Uniting, who works for Uniting, comes out and does an assessment to see if you qualify.

PN2199

And was that just a training assessor or was the assessor a registered nurse?‑‑‑We had registered nurses training assessors.

PN2200

Okay. Am I right in saying that having got the qualification you then used it to help out?‑‑‑Yes, yes.

PN2201

Bear with me, I just want to make sure it's clarified with the witness. You say in your statement you weren't involved with Schedule 8 medications, so this is just Schedule 4 medications?‑‑‑RNs have to do them.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2202

Yes. So, did the come to you if they were short handed to do this?‑‑‑Schedule 8? No.

PN2203

No, no, no, sorry. To do Schedule 4 medication rounds. Would they come to you and say look, we're short. Can you come and help out today?‑‑‑Yes. Yes.

PN2204

Okay. So - - -?‑‑‑I have to say it very rarely did happen, I'm not going to exaggerate. It was very rarely.

PN2205

But on the rare occasions it did happen, I just want to walk through the process. So - well, how rarely would it have happened?‑‑‑Very rarely. To be honest, I haven't given out medication for quite a while.

PN2206

Over a year?‑‑‑Over a year, yes, definitely.

PN2207

But you have given it out?‑‑‑Yes.

PN2208

Okay. And I don't - if you can't answer the question just say so, Ms Gauci, it's fine. So, would you be left alone to do the Schedule 4 round or would somebody be with you?‑‑‑When you're doing it, you're left on your own.

PN2209

I assume the Schedule 4 medications are in a locked cupboard somewhere?‑‑‑We have a treatment room where they're kept.

PN2210

That treatment room's locked?‑‑‑It was in the old building. Now, I'm not sure. To be honest, I'm not sure because I'm not sort of in so I couldn't tell you.

PN2211

That's fine. I take it that if the medications were tablets, they would have been in a Webster-pak or something similar?‑‑‑In the blister packs, yes.

PN2212

In the blister packs. And am I right in saying that if you do your rounds and let's assume I was one of the residents and you came to me, you have to firstly identify that what's in the blister pack - the name of the medication and you have to verify that that medication is right. Is that correct?‑‑‑No, how we were always taught is we don't need to know the name of the medication, we just need to know how much is given.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2213

So, how would you - most of the other witnesses have said that they checked off the name and they secondly have said that they were given a picture chart so that they could make sure that the tablets actually were the right tablets?‑‑‑Yes, so in blister packs they should already be done in blister packs. And then you have an iPad where the resident's name and picture and the tablets that you should be given out are on there. And you pretty much count out what is on the iPad to what is in that blister pack.

PN2214

Does the iPad have a picture of each tablet?‑‑‑It possibly could. I cannot remember, like, it's been a while but we don't - we're only CSEs, we're not RNs, we're not meant to know the names of them. We just need to know how much we're giving out.

PN2215

So, you never - when you were doing it you never actually checked that they were getting the right tablets?‑‑‑Well, you knew they were the right ones because they were already in the blister packs and that's what you did. So, you had a - you've got the morning, lunch pm, you've got to make sure that you're giving out the - if it was the morning round, the morning round, so you would check that. You would check against the person's name, their picture. You would check how many tablets were on - that were charted on the iPad. You would check that's how much you popped out and that was in there and then again you would ask the resident when you were giving them the medication that that was the correct resident you were giving it to.

PN2216

Okay. So, you would count the number of tablets against what's on the iPad but you would accept that they were the right tablets because they were in the blister packs?‑‑‑That's correct. That's correct.

PN2217

Okay, that's fine. And you would stay to observe them taking the tablet?‑‑‑Yes, you'd have to observe them, yes. You would sign off on it, so.

PN2218

Any instructions about taking the tablets such as crushing it and putting it in custard. Was that on your iPad?‑‑‑Yes.

PN2219

I take it that - go on?‑‑‑Sorry, you cut out.

PN2220

Sorry. That was on your iPad?‑‑‑What was that?

PN2221

Instructions - so if they had - if the tablet had to be crushed and put into custard or something, that would have been on the iPad?‑‑‑That's correct, yes.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2222

I take it that you would observe them taking the medication and then you would write on the iPad that they took it?‑‑‑That's correct.

PN2223

But as you say you didn't do that very often?‑‑‑No. No. But we get assessed each year so it keeps your skills up.

PN2224

And you're back (indistinct) are you?‑‑‑Yes.

PN2225

Or you might be pleased we had this meeting, you never know?‑‑‑I was thinking the same.

PN2226

Can I just take you then to this new model you've got, this new model. How do you describe your new model of care?‑‑‑The homemaker model?

PN2227

That's the phrase you use, is it?‑‑‑The home care model, sorry. I always say homemaker but the home care, yes.

PN2228

You call it home care model?‑‑‑Well, the home model or the house model.

PN2229

The house model?‑‑‑Yes.

PN2230

Are you happy with house model?‑‑‑Yes.

PN2231

Okay, we'll call it house model?‑‑‑Yes, thank you very much.

PN2232

Can I take you to your second statement, paragraph 15(a). So, I think you said you've got five houses?‑‑‑Yes.

PN2233

And how many care workers are in a house?‑‑‑I can't tell you how many workers there are to be honest with you because I'm not part of that.

PN2234

So, your knowledge of this is sort of general, it's not specific?‑‑‑Yes. Yes, in regards to the workers, yes.

PN2235

Yes, okay. I don't want to ask you unfair questions, that's all?‑‑‑Yes.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2236

So, you say 'Providing' and this is in (a):

PN2237

Providing residents care according to the resident's care plan, including catering, including laundry, individual residential activities.

PN2238

So, I just want to understand those if I can and again if you don't really understand what the model is about, let me know?‑‑‑Mm-hm.

PN2239

You don't know how many care workers are in each building?‑‑‑No, I'd only be guessing. I'm not familiar, that's right.

PN2240

No, don't guess, don't guess, that's fine. You say it includes catering?‑‑‑Mm-hm.

PN2241

You're not sure how many care workers are there, how do you know it includes catering?‑‑‑With the new model of care, what I mean by catering is that the CSEs are now more responsible for a lot more than what they used to be in the other building. Because we're trying to make it more of a homelike environment, so if the kitchen staff have come up, given out the food or whatever but two hours later another resident's hungry, then that's up to the care staff to feed that resident, or to help them, you know, put on toast or give them a meal or heat up something for them. So that's - in regards to catering, that's what we mean.

PN2242

So, you still have a central kitchen?‑‑‑That's correct.

PN2243

You still have a central dining room?‑‑‑No, there's a dining room in each household.

PN2244

Right, so the central kitchen - I'll use lunch as an example. The central kitchen produces lunch?‑‑‑Mm-hm.

PN2245

And I assume it's on - it goes into a heating - - -?‑‑‑Hot box.

PN2246

Hot box, yes. Thank you, you're very helpful. Hot box. And does somebody take that then out to the house or do they come from the house and get it?‑‑‑No, the catering staff will take that up. So we've got designated catering staff for each level, or each household.

PN2247

Okay. So, the hot box arrives at the household?‑‑‑M'mm.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2248

The catering staff unpack it?‑‑‑That's correct, and they also will serve it to the residents who are in that dining room.

PN2249

Yes?‑‑‑The staff will take the other ones to the residents who don't come out of their room for lunch. So the staff will then take it to them. Then the kitchen staff will pack it, like clean up and leave.

PN2250

And I assume that that's sort of breakfast, lunch and dinner, but in between if somebody wants a toastie or some scrambled eggs I've actually got a kitchen where I can do that?‑‑‑That's correct.

PN2251

And that's now the responsibility of the carer who's in there?‑‑‑That's correct.

PN2252

You say the carer's doing cleaning. Do you still have centralised cleaning services?‑‑‑Yes.

PN2253

So when you say they're doing cleaning what are they doing that the centralised cleaning service isn't doing?‑‑‑So each household again is designated a cleaner, but a cleaner has a schedule. They stick to their schedule. If there's something that needs to be done outside of that schedule then it's up to the staff member to clean.

PN2254

If you don't like my language just say so, but I take it that the cleaning department do what we might call the schedule heavy cleaning, the vacuuming and all of that, is that correct?‑‑‑Yes. They've got scheduled times that they clean out residents rooms, so wiping down counters as well.

PN2255

So they will be cleaning the bathrooms, toilets each morning in the normal way?‑‑‑Yes, but not every room every day.

PN2256

Is that your schedule, is it, you don't clean every room every day?‑‑‑They don't - yes, we don't - the cleaners aren't there that long, so they had a schedule, so they might do rooms, I don't know, just for argument sake 1 to 10 on this day, and then it's, you know, 11 to 20 on this day.

PN2257

Do you still have a centralised laundry?‑‑‑The laundry that we have is for sheets and towels, that heavy stuff. The residents clothing or anything personalised we do ourselves.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2258

And by saying we do ourselves are you saying that it goes to a centralised laundry or are you saying the carer now does it?‑‑‑The carers do it.

PN2259

So towels, sheets, that goes to as it were the commercial laundry, and washing my jumpers, God forbid, given they're wool, washing my jumpers would go in the washing machine?‑‑‑That's correct, and we do get in trouble for doing that - - -

PN2260

My dog once wore my father-in-law's favourite jumper, so don't worry. Then you've got individual resident activities, and I'm just trying to in the context of your new job, so the care worker is now responsible as the recreational officer for the people in your house, are they?‑‑‑Yes. So the recreational activity officer role was made redundant, and part of their role and other duties got put onto the leisure (indistinct) coordinator, and then other parts went to the household itself. So the homemaker is essentially in charge of making sure that activities get done with the support of myself to specifically make sure it gets done.

PN2261

Could you give us an example of that, a care role versus your role?‑‑‑Okay. So for example if Mother's Day is coming up and they might say we want to make flowers to put up to decorate the home I would make sure that they had the resources they need to do that activity, but they're responsible for getting that activity done.

PN2262

The care workers in the houses have they been trained in recreational activities?‑‑‑No, and either have the homemakers. So when they say model of care they're trying to make it more of a home like environment. So they would - if someone said, 'I want to do my own washing today' that would be considered an activity because that's what they would do in their home, and so with the assistance if required from a staff member they would do their own washing.

PN2263

If somebody said, 'I want to go to the zoo', who would organise that?‑‑‑I would, I do major events.

PN2264

Okay. So that would be called a major event, would it?‑‑‑Yes.

PN2265

If there was a birthday party for somebody's 90th birthday who would organise that?‑‑‑The homemaker.

PN2266

They would organise it completely or would they liaise with you in terms of getting the resources?‑‑‑They would liaise with me to get the resources. My job is to make sure they can do their job.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2267

And I think I asked this before, I don't think you were able to answer it, I will just check. Do you understand what qualifications the homemakers have got?‑‑‑The homemakers - when they - they had to have a Cert IV, but they didn't have to have it in anything in particular apparently.

PN2268

Well, you're not suggesting I could have it in sheet metal work? No, I'm not being facetious, I'm just - - -?‑‑‑I know.

PN2269

- - - when you say anything in particular you mean that they could have it in aged care, disability, something related to Human Services?‑‑‑Well, when they were going for their interview one of the interviewers turned around and said, 'You can have a Cert IV. It doesn't matter what you have it in. It could be gardening, that would benefit the home.'

PN2270

Okay. All right. That's my cross-examination. Thank you, Ms Gauci. You have a lovely weekend. I think Mr Gibian will probably want to ask you a few questions.

PN2271

COMMISSIONER O'NEILL: He may, but I will just ask Mr McKenna first. All right. Mr Gibian?

PN2272

MR GIBIAN: There is actually no re-examination. Thank you, Ms Gauci for your evidence.

PN2273

COMMISSIONER O'NEILL: Thank you, Ms Gauci, you are now free to go?‑‑‑Okay. Thank you.

<THE WITNESS WITHDREW�� [3.41 PM]

PN2274

COMMISSIONER O'NEILL: And it's Ms Little next?

PN2275

MR GIBIAN: Yes, thank you, Commissioner. I think she's joining now as I understand it.

PN2276

COMMISSIONER O'NEILL: Ms Little, are you there, can you hear me? There she is. Ms Little, are you there, can you hear me?

PN2277

MS LITTLE: Yes. Hi.

***�� FIONA KATHLEEN GAUCI�� XXN MR WARD

PN2278

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

PN2279

MS LITTLE: Sorry. Yes, sorry.

PN2280

COMMISSIONER O'NEILL: No. Terrific, all right, I can see you. I'm Commissioner O'Neill, can you hear me all right?

PN2281

MS LITTLE: Yes, I can.

PN2282

COMMISSIONER O'NEILL: Okay. Terrific. Now, my associate is just going to have you take the affirmation.

PN2283

THE ASSOCIATE: Ms Little, can you please state your full name and work address.

PN2284

MS LITTLE: Pamela Marie Little, 33 Highs Road, West Pennant Hills.

<PAMELA MARIE LITTLE, AFFIRMED�� [3.42 PM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [3.42 PM]

PN2285

COMMISSIONER O'NEILL: Mr Gibian?

PN2286

MR GIBIAN: Thank you. Ms Little, can you hear me?‑‑‑Yes.

PN2287

As I think you know I'm Mark Gibian, I'm appearing for the HSU. Can I just ask you to repeat your full name for the record?‑‑‑Pamela Marie Little.

PN2288

And you're an administration officer with Uniting Wirreanda in West Pennant Hills?‑‑‑Correct.

PN2289

And you've made two statements for the purposes of this proceeding. The first of those is dated 30 March 2021, some little time ago now. Do you have a copy of that with you?‑‑‑Yes.

PN2290

Have you had an opportunity to read through that statement?‑‑‑Yes.

***�� PAMELA MARIE LITTLE�� XN MR GIBIAN

PN2291

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

PN2292

And there are no corrections you wanted to make?‑‑‑No.

PN2293

Thank you. That's the first statement of this witness that we rely upon and wish to be admitted into evidence. It's document 158 in the electronic court book at page 10365. There is also, Ms Little, a reply statement that was prepared dated 20 April 2022. It runs to 64 paragraphs. Do you have a copy of that as well?‑‑‑Yes.

PN2294

You've had an opportunity to read that through?‑‑‑Yes.

PN2295

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

PN2296

We seek to have that as part of the evidence. It's document 159, commencing at page 10383. Thank you, Ms Little. Hopefully on the screen in front of you you can see a number of squares, one of which has Mr Ward in it, and he's now going to ask you some questions.

CROSS-EXAMINATION BY MR WARD�� [3.45 PM]

PN2297

MR WARD: Ms Little, can you hear me?‑‑‑Yes.

PN2298

Thank you, Ms Little. My name is Nigel Ward. I appear in these proceedings for the employer interests. I'm just going to ask you some questions. I appreciate it's late on a Friday, I'm going to try and finish fairly quickly if I can. I tried this earlier today and it didn't work, so bear with me. I think earlier today we sent you a copy of what we understand to be your - the enterprise agreement that covers you. Did you receive that?‑‑‑I did but that's for Hammond Care. I don't work for Hammond Care.

PN2299

Well, as I just said I tried this once today and it failed. I've tried it twice and it's failed again. I'm going to ask you to completely ignore what was sent to you. I'm going to try and do this by braille. Do you understand to be covered by the United Aged Care Enterprise Agreement New South Wales?‑‑‑Yes.

PN2300

My understanding of your evidence is that you're graded as a clerical - an administrative employee, grade 5. Is that correct?‑‑‑Yes.

***�� PAMELA MARIE LITTLE�� XXN MR WARD

PN2301

This isn't a trick question, I'm just trying to - my understanding is that that grade is the highest administration grade in the enterprise agreement. Is that correct?‑‑‑Yes.

PN2302

You have a quite senior position in the organisation?‑‑‑Yes.

PN2303

Who do you actually work for in the organisation? Who do you report to?‑‑‑The facility manager - the service manager.

PN2304

Who do they report to?‑‑‑There is a regional operations manager.

PN2305

I've only got a small number of questions. Do you have your statement in front of you, your first one?‑‑‑Yes, yes.

PN2306

Can I ask you to go to paragraph 28, which sets out your duties, tasks and skills. You'll see it starts 28, says: 'As an administration officer I am responsible for the following' - do I take it that when you say, 'as an administration officer', you're referring to you as an administration officer level 5?‑‑‑Yes.

PN2307

If you could go down to (b), (b) says: 'Up until recently, I was responsible for rostering care staff, nursing staff and the bus driver'. I take that changed?‑‑‑Yes, there is a care service employee who does higher duties two days a week and so the rostering is fairly comprehensive so she was given that role so I could concentrate on all the other elements of the position.

PN2308

Okay, and (c) then says you perform ordering all stock for United. I've just got a few questions on that. Would I be right in saying that there is financial delegation when it's for buying stock? You can only spend a certain amount of money?‑‑‑I believe there are but my manager doesn't advise me of what the limits are. But I am a fairly frugal person and I make sure that we don't overspend.

PN2309

I'm very pleased to hear that. I suppose what I'm asking is this: could you go and spend a million dollars of the organisation's money tomorrow without authority?‑‑‑No, my manager has a limit. For one purchase order I think the amount is $15,000. So I couldn't ever order anything over $15,000.

PN2310

So you operate under your manager's financial delegation?‑‑‑Correct.

***�� PAMELA MARIE LITTLE�� XXN MR WARD

PN2311

Okay. We've heard some evidence today from other witnesses about care workers ordering stock and things. In your organisation does anybody other than you order stock?‑‑‑No.

PN2312

It all is centralised under you in your organisation?‑‑‑Under the administration office, yes.

PN2313

As an administration employee level 5, do you have people working for you?‑‑‑Yes, so there's the care service employee who does higher duties two days a week and there is another administration officer who does mainly lifestyle but she's a level 3 so I give her instructions as well and sometimes get her to assist me if needed.

PN2314

If I could just go to the stock items, when you say, 'stock for all care needs', does that include medications?‑‑‑No, medications is done by the registered nurses.

PN2315

Okay. But things like - bear with me - disposable gloves and things like that, that would include that?‑‑‑Yes, so I would do the wound care. I give the list to the registered nurses, they mark down what they need for wound care, incontinence aids, PPE, toilet paper, everything.

PN2316

They identify what is required - I apologise, I'm getting an echo. I'm not sure if it's me. They identify what's required to you and then you make the purchases for them?‑‑‑Correct.

PN2317

When you say, 'kitchen stock', I take it that's restocking the pantry for the cook and things like that, is it?‑‑‑No, it's not the food, because our kitchen is outsourced to another company so they do the food. But I will do things such as bowls, knives and forks, matters to walk on, non-slips matts, brooms, things like that.

PN2318

Who would tell you that they need those?‑‑‑Normally the chef would advise me.

PN2319

So I think you said that you outsource the - - -?‑‑‑Yes, the kitchen is outsourced to a catering company.

PN2320

Right?‑‑‑So they will do their own food purchasing.

PN2321

So does your chef work for that catering company?‑‑‑Yes.

***�� PAMELA MARIE LITTLE�� XXN MR WARD

PN2322

You've got there in (iv) 'maintenance stock'. Help me out: is that like lightbulbs and things like that?‑‑‑It could be batteries, if the cleaner - who is also outsourced to another company called (indistinct), if she requires things that are not within their contract, I will purchase them on her behalf.

PN2323

So the kitchen is outsourced to a catering company, yes?‑‑‑Yes.

PN2324

Your cleaning is outsourced to a cleaning company?‑‑‑Yes.

PN2325

Is your laundry outsourced as well?‑‑‑Partially - the laundry of the sheets, towels, bath mats and so forth, that is outsourced, but personal laundry is done in house.

PN2326

Do you have a central facility for that?‑‑‑Yes, we've got two laundries with commercial washing machines and dryers.

PN2327

Can I take you to page 10 of 18, if you could go there and I'm at - just a little bit below H on page 10 of 18 with the heading, 'Property maintenance'. You say: 'Maintenance of the facility is an important part of keeping the residents safe and happy'. Is the maintenance of the facility outsourced as well?‑‑‑No, it's actually inhouse. Uniting have a property division.

PN2328

Does that mean you have staff actually on site in the maintenance team?‑‑‑Yes, we have one gentleman who handles the maintenance for the residential aged care facility and also for our independent living, which is fairly large. There's 105 units so - plus another village that he also has to look after their maintenance issues.

PN2329

Does he have the authority to outsource work to specialist contractors when they're needed?‑‑‑Yes.

PN2330

So that doesn't come through you, he would do that directly?‑‑‑Yes.

PN2331

Okay, and you say down in the same place - you say:

PN2332

When the need for maintenance is identified I will raise and monitor a request via BEIMS.

***�� PAMELA MARIE LITTLE�� XXN MR WARD

PN2333

Ms Little, what's BEIMS?‑‑‑I'm not sure what the acronym means, but what it is, it's where all manner of issues are logged. So when I log a maintenance issue for a particular room, a particular fault, then that goes to our in‑house maintenance person, who will deem whether or not he can fix it himself or he will have to outsource it, and I will monitor it to make sure that it gets fixed. So if it's outsourced to someone else, he will normally tell me, and then that service provider will come on site and fix it and then, you know, it's all been done.

PN2334

Who lets you know that it needs fixing?‑‑‑It can be a resident, it can be a staff member, it can be something that I notice myself that needs doing, or the service manager � anyone can advise. Now, they have the opportunity to either enter it in BEIMS themselves. If staff are not confident in doing that, or they can write it down in two different places, which I check every day and then I put it into the system.

PN2335

This could be there's a tap leaking in room 6 or something like that?‑‑‑Yes, or a blocked toilet somewhere or - yes.

PN2336

I take it then the BEIMS system is visible by the maintenance person. Is it a he or a she?‑‑‑It's actually a he at the moment.

PN2337

And he will work out from that list what the priority is; he'll work out from that list what he can do and what he has to outsource?‑‑‑Correct.

PN2338

Can I ask you just to turn to page 11? You talk at page 11 about the iPad‑type tablets also becoming an important part of the day worker team. You used to manage and administer medications. 'If there is an issue with the medication tablet, administration staff will (indistinct) try and solve it.' I don't want to sound demeaning when I say this, but you're not suggesting that you can take an iPad apart, are you, with that? What do you mean by 'solve it'?‑‑‑Okay - - -

PN2339

If you are, can I employ you?‑‑‑No, normally what it is, it's normally an access issue. So normally it's � for some reason it's not either connecting to our internal network, or someone in a different shift overnight has changed some settings. It needs to be reset back again so it can connect to our internet, and therefore download the latest medication profiles.

PN2340

Just lastly, I think if you go to paragraph 43, am I right in saying that when the service manager is not around, you step in as the acting service manager?‑‑‑I do, but I'm not called an acting service manager and that, but I will, yes, when he's � he's obviously very busy � when he's not available or he's offsite with residents and meetings and so forth, yes, then I will step in to his shoes and try to resolving issues that arise and need immediate attention.

***�� PAMELA MARIE LITTLE�� XXN MR WARD

PN2341

So you're sufficiently senior for him to let you exercise his delegation?‑‑‑Yes.

PN2342

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

PN2343

COMMISSIONER O'NEILL: Thank you. Mr McKenna? All right. Any re‑examination, Mr Gibian?

PN2344

MR GIBIAN: There is not, Commissioner. Thank you, Ms Little.

PN2345

COMMISSIONER O'NEILL: Thank you, Ms Little, for your evidence this afternoon, and you're now free to go?‑‑‑Thank you. Bye.

<THE WITNESS WITHDREW�� [3.58 PM]

PN2346

COMMISSIONER O'NEILL: And it's Ms Austen next?

PN2347

MR GIBIAN: It is. Thank you, Commissioner. I understand she's dialling in.

PN2348

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

PN2349

MS AUSTEN: Carol Ann Austen. It's Uniting Caroona Kalina, Rous Road, Goonellabah.

<CAROL AUSTEN, AFFIRMED�� [4.00 PM]

EXAMINATION-IN-CHIEF BY MR GIBIAN�� [4.01 PM]

PN2350

COMMISSIONER O'NEILL: Mr Gibian.

PN2351

MR GIBIAN: Thank you. Ms Austen, can you hear me adequately?‑‑‑Yes, I can.

PN2352

Can you just repeat your full name for the record?‑‑‑Carol Ann Austen.

PN2353

And you're a care worker for Uniting at the Caroona Jarman facility in Goonellabah, as I understand it?‑‑‑Caroona Kalina.

***�� CAROL AUSTEN�� XN MR GIBIAN

PN2354

You've made two statements for the purposes of these proceedings. Do you have those with you?‑‑‑Yes.

PN2355

The first of those was dated I think 29 March 2021?‑‑‑Mm‑hm.

PN2356

And runs to some 39 paragraphs over nine pages. Do you have that with you?‑‑‑Yes, I have.

PN2357

I think there was just a minor typographical error on the second page in paragraph 11, where it should say � the second word should be 'carers' in that paragraph. Other than that, is the statement true and correct to the best of your knowledge and recollection?‑‑‑Yes, it is.

PN2358

That's the first statement, Commissioner, of this witness we rely upon it, is document 150 in the digital court book, commencing at page 10168. There was also a reply statement of 20 April 2022. Do you have a copy of that with you as well, Ms Austen?‑‑‑Yes, I do.

PN2359

Have you also had an opportunity to read that statement and is it true and correct to the best of your knowledge and recollection?‑‑‑Yes, it is.

PN2360

That's the second statement that we rely upon and seek to have as part of the evidence. It's document 151, commencing at page 10177 in the digital court book. Thank you, Ms Austen. I just had one question. On the first page of your first statement at paragraph 9 at the bottom, you say you hold a Certificate III in Aged Care. I just wanted to ask when you obtained that?‑‑‑Two years ago.

PN2361

So 2020 or thereabouts?‑‑‑Yes.

PN2362

Thank you. Hopefully on the screen in front of you, you can see a number of boxes. One of them has Mr Ward in it, and he's going to ask you some questions. He's appearing for some of the employer parties in this proceeding?‑‑‑Mm‑hm.

CROSS-EXAMINATION BY MR WARD�� [4.03 PM]

PN2363

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

***�� CAROL AUSTEN�� XXN MR WARD

PN2364

Thank you, Ms Austen. As Mr Gibian said, my name is Nigel Ward. I appear in these proceedings for the major employer interests. I appreciate you coming on a Friday afternoon. I'll try to be as quick as I can. Have you got your first statement in front of you?‑‑‑Yes.

PN2365

Can I just clarify what your role is in the organisation? I understand you were required to get a Certificate III in Aged Care and you've said around 2020. That's correct?‑‑‑That's right.

PN2366

But your statement says that you leave the servery - am I right in saying that you do both servery work and care work, or am I wrong with that?‑‑‑I mainly do server work. I only do care work when they're short staffed.

PN2367

So, your primary role is in the servery if they're short a shift for a care worker, you might be asked to do that shift?‑‑‑No, I do my care - the servery work and if they're short they'll come and ask me to come and help for a short time any job that they need two people to do.

PN2368

I see. So, you could be there - you could have been there today, you might - they might all of a sudden come to you at one o'clock and say we need a hand doing a two person lift, can you come and help us?‑‑‑That's right.

PN2369

Can I start with the servery, and I apologise, I don't know your facility at all so if these questions sound silly just bear with me. I take it that your facility has a major - a primary kitchen?‑‑‑It has a central kitchen, yes.

PN2370

Central kitchen. And am I right in saying that the central kitchen is separate to the servery?‑‑‑That's right.

PN2371

Are they on the same floor?‑‑‑Downstairs.

PN2372

Downstairs. So, the kitchen's downstairs and the servery's upstairs?‑‑‑Yes.

PN2373

And does the food move from the kitchen via a lift for the servery?‑‑‑Yes.

PN2374

And is the servery inside the main dining room?‑‑‑Yes.

***�� CAROL AUSTEN�� XXN MR WARD

PN2375

So the kitchen's sort of hidden away downstairs. The meals get made, transported up to the servery and that's where you are?‑‑‑They do prep meals and they - we are doing more cooking upstairs now as in like your roasts and things like that. We cook in the servery. So, they're trying to use less of the kitchen. They do, like, putting the food into containers, sending it up for us to cook. So we cook in the kitchens, in our dining rooms.

PN2376

I'll come to that, Ms Austen, if I can. Just bear with me. I'll do this - I'll do this step by step. So, let's take breakfast, if we can take breakfast. What part of breakfast is prepared in the central kitchen?‑‑‑Nothing.

PN2377

Nothing. So, that's all done in your servery?‑‑‑Yes.

PN2378

So, you would make scrambled eggs, you would prepare the toast and things like that?‑‑‑Yes.

PN2379

Are you alone when breakfast is being prepared?‑‑‑Yes.

PN2380

So, you do that by yourself?‑‑‑Yes.

PN2381

How many residents are you doing that for?‑‑‑Forty-six.

PN2382

Forty-six. You don't have any help from anybody?‑‑‑No.

PN2383

Do I take it that having served the food - and you prepare it?‑‑‑That's right.

PN2384

Do you then take it out and serve it to the individual residents?‑‑‑I do a dining room where my servery is and I could have up to 22, 23 people for breakfast. The rest are usually bedridden, so the care staff come and get the breakfast for them.

PN2385

From your servery?‑‑‑Yes.

PN2386

And I take it that at that time of the morning the central kitchen's not operating?‑‑‑Well, they usually start about six o'clock and they start prepping meals.

PN2387

For later in the day?‑‑‑Well, they're prepping means that they prep for two days at a time, so Monday they'll deliver for Monday, Tuesday. Wednesday they deliver for Wednesday, Thursday and Friday, Saturday, Sunday is another delivery, so.

***�� CAROL AUSTEN�� XXN MR WARD

PN2388

When breakfast is finished, do I take it that you have to do all the cleaning up and washing up?‑‑‑Yes.

PN2389

When lunch is being served, is that cooked in the main kitchen or is that cooked in the servery?‑‑‑In the servery.

PN2390

In the servery. So, there's no lunch cooking at all being done in the main kitchen?‑‑‑No.

PN2391

I take it that - so, I'll just use an example. You have an oven in the servery?‑‑‑Yes, I have three.

PN2392

Three. If we were having a pork roast for lunch, would you have to prepare the roast before it goes in the oven?‑‑‑Yes. Yes.

PN2393

And you prepare all the vegetables yourself?‑‑‑Well, they're frozen veggies so we just - I put them on the stove.

PN2394

When you say 'we', by lunch time are you being helped or are you all by yourself?‑‑‑By about 10 to 12 I get a care worker that comes in and helps me dish up the lunches.

PN2395

But in terms of actually preparing the lunch, it's all on you?‑‑‑Yes.

PN2396

Sorry, just bear with me. While you're doing that, what's going on in the main kitchen. Nothing?‑‑‑No, they're prepping for the next two days.

PN2397

So, when you say prepping, what do you mean by prepping?‑‑‑Well, they're - say, our potato, they'll - it's usually frozen potato, they'll be putting that into trays for each servery. Same with, say, if we have chicken Kiev's, they'll be putting those in containers and - - -

PN2398

To go into the oven or - - -?‑‑‑Ready to go into the over.

PN2399

So, that will come up the lift into your servery and you'll put that into the oven?‑‑‑Well, every two days. They bring that up, put it in our fridges for two days and then I get it out each day.

***�� CAROL AUSTEN�� XXN MR WARD

PN2400

So, you are a cook. Am I right in saying that?‑‑‑Yes.

PN2401

You're not a qualified cook, are you? You don't have a Certificate III but you're a - - -?‑‑‑I'm a Cert III in Hospitality also.

PN2402

Right. So, you've got a Cert III in Hospitality and a Cert III in Aged Care?‑‑‑That's right.

PN2403

Is the same done with dinner? Is dinner normally hot or cold?‑‑‑It's hot.

PN2404

It's hot. And let's say we were having roast lamb for dinner?‑‑‑No, they don't have that.

PN2405

We don't have roast lamb?‑‑‑No. Don't have that one.

PN2406

Tell me what we might have for dinner?‑‑‑Well, spaghetti bolognese or - - -

PN2407

Spaghetti bolognese?‑‑‑Yes, (indistinct).

PN2408

Let's say we were having spaghetti bolognese. How much prep would be done in the central kitchen for that?‑‑‑They make all of those, the tea meals are all make in the kitchen.

PN2409

Right. So those - - -?‑‑‑They're put in the containers ready for the care staff to put into the overs to heat.

PN2410

So you would take the pre-prepared bolognese out of the lift?‑‑‑Yes.

PN2411

And you would then proceed to cook or heat it in an over or whatever?‑‑‑Yes.

PN2412

You don't - I take it then that you don't plan any menus?‑‑‑No.

PN2413

Is that done in the central kitchen?‑‑‑The catering manager does that.

PN2414

So, they provide you with enough food for the number of residents that we have?‑‑‑Yes.

***�� CAROL AUSTEN�� XXN MR WARD

PN2415

Do you work for the people in the central kitchen or do you work for somebody else?‑‑‑No, I work for Caroona Kalina.

PN2416

I'm sorry, I apologise, that wasn't very clear of me. Who's your boss?‑‑‑My boss is the manager of Caroona Kalina, the facility I work at.

PN2417

The facility itself?‑‑‑Yes.

PN2418

For the people working in the central kitchen, do they also work for the organisation or are they outsourced?‑‑‑Well, they're - no, they work for Uniting.

PN2419

Who's the most senior person in the central kitchen?‑‑‑The catering manager.

PN2420

Catering manager, and who does the catering manager work for?‑‑‑She works for the manager of the whole facility. There's three facilities in our site and there is one manager that runs the whole three, like the highest manager.

PN2421

Bear with me so I can understand this. Your boss is the manager of the part you're in?‑‑‑Yes.

PN2422

And the person who is the most senior person in the central kitchen reports to the manager of the whole place?‑‑‑That's right.

PN2423

Okay. Thank you. Can I ask you to go to your statement and could you go to paragraph 23, if you could do that for me. Have you got that in front of you?‑‑‑Yes.

PN2424

Yes. Thank you very much.

PN2425

When I first started there was always two serving staff. As of 2019 it's been one.

PN2426

So that's now you?‑‑‑Yes.

PN2427

You then go on to say:

***�� CAROL AUSTEN�� XXN MR WARD

PN2428

Prior to 2019 everything was cooked in the central kitchen and sent up hot, served immediately. Now I have to do a lot more prep and cooking.

PN2429

This change occurred around 2019, did it?‑‑‑That's right.

PN2430

At 25 you say:

PN2431

Things like bread and butter puddings and creamed rice are prepared from scratch by me in the servery.

PN2432

I am not trying to be critical, I'm just trying to understand, Ms Austen, just (audio malfunction). Does that mean you bake bread?‑‑‑No, the bread comes. We get it from your distributor.

PN2433

Yes?‑‑‑And then you make your custard and then you put the bread into it, the bread and butter pudding.

PN2434

Okay. I've got you. When you say that you make puddings from scratch are you saying that the central kitchen doesn't send you anything to help make the pudding?‑‑‑No. No.

PN2435

So where do you get the ingredients from?‑‑‑Well, I have to order the stock for that. I order the bread, I order the milk, and then I order the dry goods, cereals and all that.

PN2436

Who do you order them from?‑‑‑Bidfood, that's a distributor, yes.

PN2437

So the menu is set by Uniting?‑‑‑Yes.

PN2438

And you're told what the menu is, but for some things you order the stock to do the menu?‑‑‑Yes.

PN2439

And in 26 where you say:

PN2440

For example we cook sate lamb and marsala chicken. Both dishes are delivered to me prepared, but raw.

***�� CAROL AUSTEN�� XXN MR WARD

PN2441

That's what you were describing before where the central kitchen prepares it and you would then put it in the oven or whatever. Is that what you - - -?‑‑‑Yes, that's right.

PN2442

Sorry, just bear with me, Ms Austen. How often during the day would you be asked to be a care worker?‑‑‑Well, depending on the day itself, but it depends if they're short staffed.

PN2443

Okay. But if they're not short staffed you probably won't be asked, but if they are you will?‑‑‑Yes. Yes.

PN2444

When you did your Certificate III I take it you did your Certificate III specialising in aged care?‑‑‑That's right.

PN2445

Just give me a moment. Ms Austen, can I thank you for your evidence. Mr Gibian might want to ask you some more questions, he might not. Otherwise I wish you a happy weekend?‑‑‑Thank you.

PN2446

COMMISSIONER O'NEILL: Just before that, Mr McKenna? All right. Anything in re-examination, Mr Gibian?

PN2447

MR GIBIAN: No, thank you, Commissioner. Thank you, Ms Austen.

PN2448

COMMISSIONER O'NEILL: Yes. Ms Austen, thank you very much for your evidence this afternoon and you're now free to go?‑‑‑Thank you.

<THE WITNESS WITHDREW�� [4.18 PM]

PN2449

COMMISSIONER O'NEILL: All right. Is Ms Peacock deferred until a subsequent date; is that the - - -

PN2450

MR WARD: I think that's what we were suggesting given the hour on Friday.

PN2451

MR GIBIAN: I couldn't think he would be that unsympathetic.

***�� CAROL AUSTEN�� XXN MR WARD

PN2452

COMMISSIONER O'NEILL: All right. We have got a reasonable pace going at least, getting through it, so that's encouraging. Can I just raise one matter. I think this is directed to you, Mr Gibian, and perhaps to you as well, Mr Ward. I think the president indicated the other day for the witness statements to be provided in Word form as well. I don't think that that has come through yet. I think they have from the ANMF, but not from the other two parties. So if you could make that happen that would be appreciated, please.

PN2453

MR WARD: Of course.

PN2454

COMMISSIONER O'NEILL: Unless there's anything further we are adjourned. Enjoy your weekend and I look forward to spending next week with you.

PN2455

MR McKENNA: Commissioner, just before we do adjourn could I raise one administrative matter for Monday. One of the ANMF witnesses Robert Bonner will not be available on Monday. He's not well I am sorry to say. We will inform the Commission as soon as we can when we know when it's likely that he would be available.

PN2456

COMMISSIONER O'NEILL: All right. Thank you for that.

PN2457

MR McKENNA: Thank you.

PN2458

COMMISSIONER O'NEILL: The Commission is now adjourned. Thank you.

PN2459

MR WARD: Thank you, Commissioner.

ADJOURNED UNTIL MONDAY, 02 MAY 2022 �� [4.20 PM]

LIST OF WITNESSES, EXHIBITS AND MFIs

MARK CASTIEAU, AFFIRMED........................................................................ PN974

EXAMINATION-IN-CHIEF BY MR GIBIAN.................................................. PN974

CROSS-EXAMINATION BY MR WARD......................................................... PN991

RE-EXAMINATION BY MR GIBIAN............................................................. PN1179

THE WITNESS WITHDREW........................................................................... PN1212

PAUL REGINALD JONES, AFFIRMED......................................................... PN1244

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN1244

CROSS-EXAMINATION BY MR WARD....................................................... PN1255

RE-EXAMINATION BY MR GIBIAN............................................................. PN1373

THE WITNESS WITHDREW........................................................................... PN1395

VIRGINIA ELLIS, AFFIRMED........................................................................ PN1405

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN1405

CROSS-EXAMINATION BY MR WARD....................................................... PN1420

RE-EXAMINATION BY MR GIBIAN............................................................. PN1708

THE WITNESS WITHDREW........................................................................... PN1741

DONNA LOUISE KELLY, AFFIRMED.......................................................... PN1749

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN1749

CROSS-EXAMINATION BY MR WARD....................................................... PN1767

THE WITNESS WITHDREW........................................................................... PN1854

JADE GILCHRIST, AFFIRMED...................................................................... PN1866

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN1866

CROSS-EXAMINATION BY MR WARD....................................................... PN1896

RE-EXAMINATION BY MR GIBIAN............................................................. PN1956

THE WITNESS WITHDREW........................................................................... PN1964

KERRIE ANN BOXSELL, AFFIRMED........................................................... PN1969

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN1969

CROSS-EXAMINATION BY MR WARD....................................................... PN1986

RE-EXAMINATION BY MR GIBIAN............................................................. PN2116

THE WITNESS WITHDREW........................................................................... PN2125

FIONA KATHLEEN GAUCI, AFFIRMED..................................................... PN2139

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN2139

CROSS-EXAMINATION BY MR WARD....................................................... PN2152

THE WITNESS WITHDREW........................................................................... PN2273

PAMELA MARIE LITTLE, AFFIRMED........................................................ PN2284

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN2284

CROSS-EXAMINATION BY MR WARD....................................................... PN2296

THE WITNESS WITHDREW........................................................................... PN2345

CAROL AUSTEN, AFFIRMED........................................................................ PN2349

EXAMINATION-IN-CHIEF BY MR GIBIAN................................................ PN2349

CROSS-EXAMINATION BY MR WARD....................................................... PN2362

THE WITNESS WITHDREW........................................................................... PN2448