Report into St Basil's and Epping Gardens COVID-19 outbreaks highlights failures

Two nursing homes at the centre of Melbourne's deadly COVID-19 outbreak were inadequately prepared for emergencies and had insufficient infection prevention and control procedures, and the surge workforce sent in to help had not worked in aged care before and was "unsure what to do".

An independent review of the outbreaks at St Basil’s Homes for the Aged and Heritage Care’s Epping Gardens, conducted by Professor Lyn Gilbert and Adjunct Professor Alan Lilly, found the homes had deteriorated to a shocking state during the crisis.

"I've never seen anything as appalling as this in Australia in terms of healthcare provided to Australians," Luis Prado, the chief medical officer of Epworth Hospital, told the review. During the outbreak Dr Prado had visited St Basil's in Fawkner, where 45 people died.

The review also found that a St Basil's manager told replacement staff after the permanent staff had been stood down and the home taken over by the state government that "she was not to be contacted ... and that, since they had been stood down, neither she nor St Basil’s staff were to have any ongoing involvement".

The outbreaks at St Basil’s and Epping Gardens, where 38 people died, were among the largest during Victoria's second wave.

“These stark numbers do not begin to convey the trauma and grief suffered by all residents, whether or not they developed COVID-19, and the enormous impact on families,” the review authors found.

Sue Cashman's 96-year-old mother Peggy contracted coronavirus in Epping Gardens and survived. "But she’s not in a good way," Ms Cashman said, adding the events had accelerated her mother's dementia.

"I used to own a childcare centre. If I was licensed to have 148 children, which is what Epping Gardens had, and 38 children died, people would be after my blood. Because they are old people ... people think because they are old they were going to die anyway."

Christine Golding, whose 84-year-old mother Efraxia died after contracting coronavirus at St Basil's, said the report showed "what a horror show" it was inside the facility.

But she said it was a "whitewash" for the Commonwealth government. "It doesn't really refer to them or their role in stopping this happening.

"What's missing from the review is accountability – they talk about systemic failures, but who was ultimately responsible for the neglect?"

The report found both facilities had poor emergency planning, or plans that relied on external resources, although it found that, such was the scale and number of outbreaks in Victoria, any amount of planning may not have been sufficient.

Both facilities had inadequate staff training and controls in key aspects of infection prevention and control, despite “multiple reminders to providers to prepare for a potential COVID-19 outbreak”.

The review found leadership faltered at both Epping Gardens and St Basil’s, with COVID-19 outbreaks becoming established before effective responses were put in place.

The chief executive of Epping Gardens, Greg Reeve, said the report was “a pretty honest account” of what had occurred, but said much of the blame should be sheeted home to the federal government, not the operators, who were dealing with extraordinary circumstances.

He said throughout the outbreak at his centre, the Commonwealth tried to tell him that, since Epping Gardens was the approved provider, it had to deal with the problem.

“I totally accept that, but our problem was that we did not have any staff – there was no one here. So I kept telling them, ‘You can make it my problem as much as you like, but without any staff, I can’t get the residents looked after.’ ”

The report found surge workforce planning was inadequate and exacerbated by a growing scarcity of staff across the sector at the time, and it highlighted ongoing challenges in communications between the facilities and the Health Department.

Minister for Aged Care Services Richard Colbeck said it was important to understand what occurred to help “make sure we can prevent similar outbreaks now and into the future”.

But opposition health spokeswoman Julie Collins said the report showed the federal government did not have a COVID-19 plan for aged care, and it had failed to learn from earlier aged care outbreaks in NSW.

“The Morrison government’s failings are heartbreaking and completely unforgivable,” she said. “This could have been avoided if the Morrison government had a proper plan for COVID-19 in aged care and learnt from previous mistakes.”

A Victorian government spokesperson said: "With public health data showing that over a quarter of outbreaks were most likely caused by staff working across multiple sites, we ... believe that it was too soon for the Commonwealth to end the wage subsidy to support staff to work at only one facility. In Victoria's public sector, this subsidy is in place until the end of February at least. We also believe it is vital that the Commonwealth embeds minimum staffing levels across the sector to improve the health outcomes for residents."

If you or anyone you know needs support call Lifeline on 131 114 or Beyond Blue's coronavirus mental wellbeing support service on 1800 512 348.