Aged Care - our submission to the Royal Commission

LONG READ: Our previous post highlighted issues that people who were in care as children can face on entering into the aged care system, particularly where those services are provided on sites previously used for the institutional care of children. Below is our submission into the Royal Commission into Aged Care Quality and Safety 

The Find & Connect web resource is funded by the Department of Social Services to document the history of child welfare in Australia. The resource assists people who grew up in out-of-home care, including Forgotten Australians, Former Child Migrants and members of the Stolen Generations, discover and access information and records about their time in care. It is managed by the Find & Connect web resource team, based at the University of Melbourne. 

Introduction 

This submission responds to the issue of Diversity in Aged Care, specifically the special needs of people who spent their childhood in institutional care. It relates to the Royal Commission’s Terms of Reference a) and e): 

  • a) the quality of aged care services provided to Australians, the extent to which those services meet the needs of the people accessing them, the extent of substandard care being provided, including mistreatment and all forms of abuse, the causes of any systemic failures, and any actions that should be taken in response;
     
  • e) how to ensure that aged care services are person-centred, including through allowing people to exercise greater choice, control and independence in relation to their care, and improving engagement with families and carers on care-related matters. 

The current Aged Care Diversity Framework recognises that ‘older people with diverse needs, characteristics and life experiences can share the experience of being part of a group or multiple groups that may have experienced exclusion, discrimination and stigma during their lives’, and aims to ‘address perceived or actual barriers to consumers accessing safe, equitable and quality aged care’. 

There are currently half a million Care Leavers in Australia between 40 and 90 years of age (Aged Care Diversity Framework, Appendix 1). Their requirements for appropriate aged care are both immediate and increasing. 

Making a bed in a dormitory at the Home of the Good Shepherd girls home.

Making a bed in a dormitory at the Home of the Good Shepherd girls home.

Care Leavers have been recognised as a group of people with special needs in Section 11.3 of the Aged Care Act 1997. However, despite the significant barriers to accessing aged care, including that they may be returning to the same organisations, locations and in some cases the same buildings where they experienced abuse in childhood, they have not yet been recognised in the Aged Care Diversity Framework with a specific Action Plan. The development of an action plan to complement the information resources already available would greatly assist aged care service providers to address the specific barriers and challenges faced by Care Leavers. 

Recommendation 

Develop a specific Action Plan for Care Leavers, giving particular recognition to the issue of being re-institutionalised into the same places, and with the same organisations who caused them harm in childhood.

Develop a specific Action Plan for Care Leavers, giving particular recognition to the issue of being re-institutionalised into the same places, and with the same organisations who caused them harm in childhood. 

Background 

There is a close historical connection between the aged care system and Australia’s history of children’s institutions. Without adequate consideration of this history, and its continued impact on those who spent time in care as children, safe, appropriate and sensitive aged care will not be provided to a vulnerable population. 

Care Leavers cannot access appropriate services without their particular needs being recognised within the Aged Care Diversity Framework, and the development of a specific Action Plan to ensure they have access to safe, equitable and quality aged care. 

People who were in institutional care as children were not provided the opportunity to exercise choice, had little control or understanding of the circumstances of their lives, and were unable to exercise the independence many of us took for granted throughout childhood and adolescence. Strictures on the choice, control and independence of this group, therefore, has a profound impact on their quality of life, to a far greater extent than those who did not experience out-of-home care. 

Inasmuch Home ['Washing Day']

Inasmuch [‘Washing Day’]

Where their families were known to them, letters from parents and siblings, birthday cards and other forms of communication may have been withheld from them. The deliberate withholding of information and interference in family relationships by care providers in the past has resulted in issues of aged care being of great concern to them. 

Former residents have provided evidence to various inquiries into the abuse suffered by children in institutions, including the ongoing trauma and impacts of their childhood experiences. As noted in Real Care the Second Time Around (pdf), as Care Leavers age, in many cases prematurely, the prospect of returning to care provokes a range of emotions, including intense fear. This is exacerbated at the prospect of returning to the very same institutions and organisations where childhood trauma occurred. 

Many sites of former children’s institutions are now the sites of aged care facilities; and are provided by the same organisations responsible for children’s institutions in the past. These organisations include those that were the subject of case studies at the Royal Commission into Institutional Responses to Child Sexual Abuse (2012-2017). Aged care services provided by these same organisations in these same locations cannot meet the needs of Care Leavers to access safe and appropriate care following the abuse or neglect they were likely to have experienced as children. 

Understanding the links between aged care and children’s institutions, and the implications for Care Leavers of being in the same or similar institutions run by the same or similar organisations, is vital for those involved in the provision of aged care. Empathy towards and understanding of the history of child welfare and how it continues to affect Care Leavers is imperative in ensuring this group receives sensitive and appropriate care. 

Subiaco Orphanage Industrial School for Roman Catholic Boys

Subiaco Orphanage Industrial School for Roman Catholic Boys

Our included Appendix provides a list of aged care facilities that are former children’s institutions. The aged care facility may also be provided by the same organisation that had been responsible for the children’s institution. In some cases, original buildings that housed the institution have been demolished and replaced with a retirement village. In other cases, the children’s institution has simply been taken over by another organisation and repurposed as an aged care facility. The names of former children’s institutions have, in many cases, also carried over to the aged care facility, which may also cause distress for Care Leavers. 

We commend the information package produced by the Department of Health in 2016:
Caring for Forgotten Australians, Former Child Migrants and Stolen Generations: an information package for aged care services. We also note the recent publication of Forgotten Australians: Real Care the Second Time Around (pdf). These resources contain vital information to help providers of aged care understand the concerns, fears and anxieties of Care Leavers and their need for appropriate, sensitive and trauma-informed care.  

Former children’s homes that are modern aged care facilities: three examples 

Nazareth House Camberwell 
In 2019, the Sisters of Nazareth run 3 aged care facilities at the former sites of children’s institutions. Nazareth House Ballarat (in Victoria) operated from 1888 to 1976; Nazareth House Camberwell (Victoria) housed children between from 1953 to 1975 and Nazareth House, Geraldton (Western Australia) was a children’s home from 1941 to 1979. 

When it was originally established in 1929, Nazareth House Camberwell was a Home for the Aged. In 1949, the Sisters of Nazareth were approved by the Commonwealth Government as an organisation that could receive child migrants from Britain, and part of Nazareth House began to be converted into a children’s home. By the early 1950s, Nazareth House Camberwell comprised a residence for 100 elderly women, a residence for 45 elderly men, and the children’s home which had capacity for 150. 

Nazareth House Camberwell

In total, Nazareth House Camberwell received 53 female child migrants from Britain. From 1958, the institution also housed children from all over Victoria: girls aged between 2 and 15, and boys aged between 2 and 9. In the 1960s, Nazareth House had capacity for up to 60 children, within the complex that also continued to house elderly residents. Residential care for children at Nazareth House Camberwell ceased in 1975. 

The Senate’s 2004 Forgotten Australians final report included the recollections of two former residents of Nazareth House Camberwell. One described her time there as ‘a very painful period in my life to talk about in fact I still have nightmares especially when I have to revisit memories. I have come to realise that we were never children. We were an unpaid workforce, with no reward just punishment’ (Submission 169). Another submission described abuse in Nazareth House including force feeding, beatings and the use of restraints on girls who lived there (Submission 5). For many who lived there as children, Nazareth House Camberwell holds painful memories of abuse, separation from home and family and loss of identity. 

Annesley Court, Mayfield, NSW 
Annesley Court Mayfield is a retirement community in Newcastle, NSW, run by Uniting (a community services ministry of the Uniting Church in NSW and the ACT). The site has housed two former children’s institutions. From 1926 to 1942, a property known as ‘Winncourt’ was the St Elizabeth Girls’ Home. From 1952 until 1964, it was the St Alban’s Home for Boys, run by the Anglican Diocese of Newcastle. 

St Alban’s Home for Boys

(St Alban’s Home for Boys moved around during the 60 years of its operation. Its first site at ‘Bishopscourt’ in Morpeth is now Closebourne Village, run by LendLease.) 

The 42nd case study of the Royal Commission into Institutional Responses to Child Sexual Abuse was into the Anglican Diocese of Newcastle which ran St Alban’s Home for Boys. Numerous former residents of St Alban’s Home for Boys have spoken out about the sexual, physical, and mental abuse that they endured at the Home. A former resident, “John”, gave an interview for an ABC article in 2016 about his experiences at St Alban’s in the 1960’s when it was located in Mayfield. He said it was a ‘dark place he would like to forget’. 

Barrington Lodge, New Town, TAS 
Barrington Lodge Aged Care Centre in the Hobart suburb of New Town is run by the Salvation Army. Based in a building that dates back to 1850, its website describes the lodge as ‘rich in history’, providing ‘a cosy, comfortable home with mountain and park views’. 

Barrington Boys’ Home

From 1946 until 1981, the site was Barrington Boys’ Home, also run by the Salvation Army. According to the 2004 report by the Tasmanian Ombudsman, Listen to the Children: Review of claims of abuse from adults in state care as children, Barrington Boys’ Home was an institution ‘frequently named by claimants’. The report states that ‘the information suggests that abusive practices were not necessarily widespread amongst staff; rather, the evidence suggests that a relatively small “hard core” of staff members were involved in the abuse of a large number of boys over a long period. This was particularly evident at … Barrington Boys’ Home’ (Tasmanian Ombudsman, 2004). 

Conclusion 

We provide these examples to raise awareness of the close connections between the history of children’s institutions and the modern aged care system, and to highlight the vital importance of understanding how past traumas can be triggered by the prospect of going into aged care. For Care Leavers to be provided with safety, dignity and respect in aged care, it is vital that awareness is raised about the special needs of Care Leavers and the history of institutionalising children in Australia, a history that caused harm to so many people. 

Appendix: list of former children’s institutions that are today aged care facilities 

Note: This list is drawn from the Find & Connect information about children’s homes and correlating these with current aged care facilities. It is likely that there are more which have not yet been identified. 

Not all aged care homes listed are in the same buildings used originally for children’s homes. In some cases, the original children’s homes buildings have been demolished and newer facilities built for the aged care home, but are still on the grounds of former children’s homes. 

New South Wales (24 locations identified) 

Victoria (19 locations identified) 

South Australia (4 locations identified) 

Tasmania (8 locations identified) 

Western Australia (10 locations identified)

Queensland (4 locations identified) 

Northern Territory (1 location identified) 

Sources 

Lewis Blayse, ‘Some more Salvation Army Children’s Homes’, 12 January 2014.

Department of Health, Caring for Forgotten Australians, Former Child Migrants and Stolen Generations: an information package for aged care services, 2016.

Find & Connect web resource

Helping Hand, Forgotten Australians: Real care the second time around (pdf) 2019.

Anne Manne, ‘Rape among the lamingtons’, The Monthly, May 2017.

Ombudsman Tasmania, ‘Review of Claims of Abuse from Adults who were in Care as Children’, November 2004.

Royal Commission into Institutional Responses to Child Sexual Abuse, Case Study 42: Anglican Diocese of Newcastle, 2016.

Senate Community Affairs Reference Committee, ‘Forgotten Australians: a report on Australians who experienced institutional or out of home care as children’, 30 August 2004.