But when they found more than 60 tablets hidden throughout her room, and found faeces on two sets of “clean” pyjamas, they said they knew they “had to get her out of there”.

Janelle Solomou said her aunt, Patricia Anson, was given a single dose of paracetamol in 24 hours after breaking her wrist in an unwitnessed fall at the Peter Sinclair - RSL Life Care nursing home in May, 2017.

She said it was the family that took the “very distressed” Mrs Anson to hospital for treatment, a full day after her fall, because the facility had not arranged transport - despite her aunt being in “substantial pain”.

“During her emergency department consultation, they also found a large egg-shaped lump on the back of her head that the facility had not even seen or reported on,” Mrs Solomou wrote in a formal letter to the Aged Care Complaints Commission in July, 2018.

For four years, Mrs Anson - now 83 - had been happy and comfortable at the facility, Mrs Solomou said.

Mrs Anson had moved into the aged care home with her husband - John - in 2012, after she was diagnosed with dementia.

“They had been there for about four years before my uncle passed away in February, 2015,” Mrs Solomou said.

“She was there for another 12 months before things started to go downhill.

“They had a change in management, and the care just dropped.

“The carpets stopped getting cleaned as often, and they just stopped doing a lot of things that were typical for the facility.

“We just found everything was a bit dirty.”

In her complaint letter to the Aged Care Complaints Commission, Mrs Solomou said they had signed a "PRN" form in January, 2017, for a "chemical restraint" to be administered to Mrs Anson when needed.

Mrs Solomou said the family had been told it would only be used when "all other" interventions were exhausted, but they did not believe this was the case given Mrs Anson's "disorientation" once the form was signed.

In a meeting with management, they requested the previously signed restraint form be "void", and that no other restraints were to be used.

But the family claims Mrs Anson was being put in a “restraint chair” without the appropriate paperwork.

“They were putting her in a restraint chair and just sitting her in the common room all day, when we had specifically said we didn’t want that to happen," Mrs Solomou said.

"She would be left at the dinner table in a wheelchair for up to two hours before being returned to her room."

They had found a dirty wash cloth - soiled with urine and faeces, on the door handle of Mrs Anson's room.

“We went to get her clean pyjamas out of her clean clothes drawer, and they were covered in faeces,” Mrs Solomou said. “Not just one pair, but two different pairs.

“They started locking her out of her room. And she had numerous trips to hospital for injuries caused by random falls. It was awful.

"We found 60 tablets hidden all around her room, so they weren’t monitoring her medication. It was at that point we knew we couldn’t leave her there."

Mrs Anson suffered a stroke during her time at the nursing home.

“Pat did start to deteriorate after my uncle died. She had dementia, and she couldn't voice her opinions as much. She couldn’t ask for help, and she was becoming very frightened and withdrawn," she said. "You just don’t know what happens when you’re not there. We knew something was going on, but we couldn’t prove it."

Mrs Solomou said she was "in disbelief" that the facility managed to meet all 44 of the standards of care required for accreditation after what they had witnessed.

"After my letter I had a few phone calls back and forth with the Aged Care Commission, and they said there was nothing they could really do," she said. "At the end of the day I think they agreed to do a couple more surprise visits throughout the year.

"It was pretty shattering, actually. The reason we put her there was so we could be safe in the knowledge she was being looked after while we were going about our lives too, and we could go and see her each week and she would be fine. But that stopped happening."

Mrs Solomou said between her, her sister and her mother, they took it in turns to drive to Hawks Nest to keep an eye on things at the nursing home.

"We couldn’t keep that up. We had to do something, but we felt stuck."

Mrs Solomou said she was "visibly upset" while visiting former colleagues at Rethink Financial Planning when one of the newer staff members, Sam Geelan, offered to help.

"She is an aged care specialist, and she showed us options when we didn’t think we had any," Mrs Solomou said. "You pay a lot of money for these facilities, and we didn’t have any more money.

"We didn't know how to go about getting a spot in a facility we were happy with, or even where to go to find a facility that was recommended - because there would be nothing worse than moving her from one facility because it was awful, to another that was just as bad or worse.

"I had no idea where to start, I just knew we needed to move her."

With Ms Geelan's help, they found an alternative aged care facility for Mrs Anson in Mayfield, where they say she has been happy - despite further deteriorating with dementia and suffering another stroke. Mrs Solomou said Mrs Anson had had some falls at the new facility too, but none that had resulted in injuries.

An RSL LifeCare spokesperson said a new facilities manager and a new general manager had been appointed from within RSL LifeCare to lead Peter Sinclair Gardens in June and September, 2016, respectively.

"Regular care meetings continued with Mrs Anson’s sister and two nieces to discuss Mrs Anson’s progressive and ongoing care needs," he said. "During these discussions it became clear that Mrs Anson’s three family members were divided on the care protocol and declined the home’s recommendations for falls prevention strategies.

“Mrs Anson’s family subsequently made a formal complaint to the Aged Care Complaints Commission relating to a series of falls Mrs Anson sustained between May, 2017, and March, 2018. The Commission found that all post-fall management procedures were followed during the course of Mrs Anson’s care, and it closed the case."

Mrs Anson was "discharged" from Peter Sinclair Gardens on March 26, 2018.

“The Aged Care Quality Commission conducted a regular audit of Peter Sinclair Gardens in April, 2018, and subsequently re-accredited the home according to all review criteria," he said.

“We have reached out to the family and are happy to discuss our care standards with them at any time.”

A spokesperson from the Aged Care Quality and Safety Commission said all complaints received were given "careful attention".

"The former Aged Care Complaints Commissioner, whose functions were transferred to the new Aged Care Quality and Safety Commission, received a complaint about Peter Sinclair Gardens facility from Ms Patricia Anson’s family," she said. "The former Complaints Commissioner worked with the family and service provider to resolve concerns and the complaint was closed on 24 September 2018.

"The former Australian Aged Care Quality Agency conducted a re-accreditation audit of Peter Sinclair Gardens... and the facility was accredited for three years. The Commission will continue to monitor Peter Sinclair Gardens through unannounced monitoring visits to ensure that the provider meets the standards."

Ms Geelan, of Rethink, said families often felt "locked in" to aged care contracts, and it could be overwhelming.

"There are solutions and alternatives," she said.

"The government changes the rules frequently, so you just need to know the financial implication of changing.

"For these clients, they were pre-July 2014, so they had a whole different set of legislation and rules. Prior to July 2014, you had a lump sum amount, you paid that, and there was an income-tested amount.

"Now it is a different amount, and in some cases it can be slightly more expensive up front, and then ongoing fees can be slightly more expensive as well, but we can break it all down for them so that they understand it, and put it into perspective and help them work out what is important to them."

Ms Geelan recommended people arm themselves with information about upfront costs, ongoing costs and how they were calculated for aged care services, including home care services.

She also advised families to look into the status of current or historical sanctions on nursing home facilities via myagedcare.gov.au.

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