[Oakden residents] lacked any voice themselves. They were entirely dependent upon others for their care and their safety”. – Commissioner Lander, p190 1
There are many lessons to be learned from the report by Commissioner Bruce Lander QC on the events at the Oakden nursing home, many of which can be applied to other facilities in our state.
Residents of the Oakden facility should have been protected from abuse and mistreatment by layers of overlapping protections which were the the domains of many different people at different levels of government, administration and service provision.
They, their families and the community, would have expected government and senior departmental officers to provide adequate resourcing and oversight and to have policies and procedures in place to ensure suitable levels of care, management and supervision. The training and professional standards of the staff working there should have provided another level of protection. Effective complaints procedures for residents and concerned others should have provided additional safeguards as should have accreditation inspections by external bodies.
Finally, the residents of Oakden relied on community visitors to bring an independent and critical eye to the conditions they experienced.
Commissioner Lander set out in forensic detail how each of these layers of protection failed and his report sounds a warning for any organisation that provides care for vulnerable people in a closed or secure environment. Regarding the operation of the relevant community visitor scheme (CVS) –
…consideration needs to be given as to whether the CVS in its current form is an appropriate safeguard for those suffering mental illness who are housed or treated in treatment centres, limited treatment centres, or authorised community mental health facilities. [p307]
Commissioner Lander’s critique of aspects of community visiting at Oakden raised questions for all such schemes, not just those visiting mental health services. The Guardian’s Office is currently in the process of establishing two separate community visitor schemes, so the issues he described are instructive as we attempt to craft models for the protection and wellbeing of young people in residential care and in youth detention. These are some of the issues.
Should schemes use volunteers or paid visitors?
Volunteers are assumed to bring into the institution expectations and standards reflecting those of the broader community. Because volunteers are not paid, that could potentially mean larger numbers of visitors within a given budget allowing more frequent visits. But is it reasonable to expect volunteers to accept the rigorous selection process, training and complex tasks required of a visitor? Commissioner Lander noted that some visitors to Oakden may not have had the necessary skills and support to identify problems, report them and intervene on behalf of residents. He favours a model in which visitors are paid, comprehensively trained, and operate within a rigorous model that has sound documentation and effective accountability mechanisms…
This is the first part of a longer paper which goes on to consider the use of volunteers as visitors, the concept of visiting versus inspection, unannounced visits, visitor independence and the place and value of visitor programs. For the full version, download Community visitor programs – what we can learn from Oakden.