Second Oakden manager banned from nursing for 12 years

18 Jan 2024

The second of three managers of the Older Persons Mental Health Facility in Oakden (Oakden) has had their nursing registration cancelled and has been disqualified from applying again for 12 years. 

The South Australian Civil and Administrative Tribunal (the tribunal) found Mr Kerim Frederick Skelton had failed to adequately supervise and manage staff for the care of vulnerable, elderly people who were, in many cases, suffering from significant disabilities or other medical conditions. 

Mr Skelton was the Nursing Director at Oakden between 2010 to 2016 and had over 30 years’ experience as a nurse. Mr Skelton’s responsibilities included clinical governance and ensuring a safe and correct model of care for residents. 

An Australian Health Practitioner Regulation Agency (Ahpra) investigation into Mr Skelton’s conduct during his time at Oakden resulted in the Nursing and Midwifery Board of Australia (NMBA) referring him to the tribunal.

The tribunal supported the Board’s opinion that Mr Skelton:

• did not perform all of his responsibilities as Nursing Director of Oakden with regard to clinical governance and model of care,
• did not ensure accountability for standards of nursing care at Oakden, with no evidence that he advocated for any additional resources to ensure the correct model of care,
• failed to ensure effective training of Oakden staff,
• did not maintain a cycle of quality improvement processes at Oakden,
• had a defensive attitude to complaint management and refused to investigate complaints against staff and
• failed to maintain robust communication with clinical leaders or senior health management at Oakden, and failed to communicate the expected standards of practice to nursing staff.

The Ahpra investigation followed the February 2018 Independent Commissioner Against Corruption’s report Oakden A Shameful Chapter in South Australia’s History, which found residents suffered neglect due to a shortage of staff to the point the facility was ‘medically unsafe, as well as reports of patients being assaulted.

The tribunal found Mr Skelton’s actions ‘constitutes professional misconduct because it comprised one or more instance of unprofessional conduct that, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience’. 

In deciding a sanction the tribunal took into account the many years failures took place under Mr Skelton’s watch, the lack of action he took to address them, and his failure to take adequate steps to prevent the excessive or inappropriate use or restraints by Oakden staff.

The tribunal also considered Mr Skelton’s co-operation with the hearing and a personal statement ‘in which he expressed his contrition and remorse for the failings that he was part of at Oakden, and his shame at the allegations made against him and at what has come to light about Oakden more generally’. He acknowledged that ‘his failings were significant and warrant a clear message being sent to him and other nurses that such failings cannot be allowed to happen again’.

The tribunal found that Mr Skelton had engaged in professional misconduct and ordered that he:

• be reprimanded,
• have his registration cancelled,
• be disqualified from applying for registration as a health practitioner for a period of 12 years from the date of the order, and
• be prohibited from providing, whether as employee, contractor, manager or volunteer, and whether directly or indirectly, any health service until he is granted registration as a health practitioner under the National Law.

Mr Skelton is the second former Oakden manager banned from nursing in recent months, following the 10-year suspension handed down by the tribunal to Julie Harrison for her ‘appalling conduct over a prolonged period’.

In it’s latest finding, the tribunal commented that as Mr Skelton has not practised since 2018 and thus has no recency of practice, he would face lengthy requalification hurdles if he were to seek work again as a nurse in the future. 

The NMBA Chair, Adjunct Professor Veronica Casey AM welcomed the result. 

‘These vulnerable residents put their trust in nurses, managers and facilities to care for them when they need it most and it’s important that this trust is upheld’, Adj Prof Casey said.

‘A disqualification as long as this highlights the severity of what went on at Oakden and sends a strong message to those in the industry that we must maintain safe and supportive work environments at all levels.’ 

Ahpra CEO, Martin Fletcher, said the tribunal outcomes support the work of Ahpra and the NMBA.

‘The shameful failures that took place at Oakden must never be repeated, and these outcomes send a powerful message to the entire health workforce to always put the welfare of patients as your paramount priority,’ Mr Fletcher said.

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