The moment you see it
You help your mother shift in her chair and you see a wound: on the sacrum, the heel, the hip. Redness that does not blanch under a finger, or skin already broken.
You ask, and you are told it happens, that it is her age, that her skin is thin.
Older skin is fragile. But a pressure injury is not inevitable: it is the result of sustained pressure in one place, and preventing it is expected care, not a favour.
The Australian advantage: it is a reported number
This is what makes the conversation different here. Residential aged care providers must collect and report pressure injuries every quarter under the National Aged Care Mandatory Quality Indicator Program, alongside falls, unplanned weight loss, medication management and restrictive practices. Those results feed into the star ratings published on My Aged Care.
So you are not limited to impressions:
"What did this home report for pressure injuries in the last quarters, and how does that compare with the national average?"
The provider has that figure. It is required to collect it. A home that walks you through its numbers and its skin care program is working on the problem; a home that cannot produce them has told you something else.
What should have happened
- A skin integrity assessment on entry, using a recognised risk tool, repeated regularly and whenever her condition changes — after a hospital stay, weight loss, a period in bed.
- Scheduled repositioning, documented, rather than decided by how busy the shift is.
- Pressure-redistribution equipment: mattress or overlay, a proper cushion in the chair, heel offloading.
- Nutrition and hydration. Unplanned weight loss is itself a reported quality indicator, and it is a direct pressure injury risk factor — the two questions belong together.
When an injury appears anyway, the question is not who is to blame but: which of those four was not done, and since when? The care record can answer that.
The four records to request in writing
- The skin and risk assessments: on entry and the most recent.
- The repositioning record for the last fifteen days.
- The wound care plan: who assessed it, what stage, what dressing, how often, who reassesses.
- Weight and intake records for the last three months.
Send them in one email to the facility manager and the clinical manager, with a response date, and ask for a care plan review meeting with the updated plan provided in writing afterwards.
What to ask for immediately
- A wound specialist review or referral. A wound that has not improved in three weeks needs another set of eyes, and the home should be able to name who it calls.
- Dated photographs at each reassessment, in the record. It is the best tracking tool and it concentrates attention.
- Pain treated. Pressure injuries hurt, including in someone who can no longer say so. Ask for an appropriate pain assessment.
- The equipment, in writing: which surface, since when, who ordered it.
Where to escalate
- The facility manager, in writing, with the four requests and a date.
- A free, independent aged care advocate. They will help you word it and come to the meeting — having one in the room changes the tone.
- The Aged Care Quality and Safety Commission. Skin integrity sits squarely within the quality standards, and you can complain confidentially or anonymously.
- Ask whether it was reported. A severe facility-acquired pressure injury may fall within the serious incident scheme as neglect: "Has this been reported, on what date, and can you confirm in writing?" is a question with a paper trail behind it.
- An independent medical opinion from outside the home before any formal claim.
Before you choose a home
If you are still looking, do two things: check the star rating and the quality indicator results on My Aged Care, then ask on the tour "who does the skin assessment on entry, and what were your last pressure injury numbers?" Comparing the answer with the published figure tells you as much about the home's honesty as about its clinical care.
The practical point
A pressure injury is not a consequence of age: it is pressure that lasted. Look up the reported numbers, request the four records in writing, insist on a wound specialist and dated photographs, get the pain treated — and bring in an advocate and the Commission if the documentation is not there.
If you conclude this home is not the right one, Curalune Care Help gives you the starting point: 3 to 5 suitable homes matched to the real situation within 24 working hours, with contact details, links and a ready-to-send message to all of them at once. A$109, one-off. If you don't receive at least 3 homes matching the area and criteria you gave us, we refund you in full. Start here
The quality indicators collected, star rating methodology, quality standards, serious incident reporting obligations and complaint pathways are set by Australian Government aged care legislation and are revised regularly; clinical guidance on pressure injury prevention is updated independently. Free help is available from an aged care advocate and the Aged Care Quality and Safety Commission, and an independent medical opinion is worth obtaining before any formal claim. This article is general information and is not legal or medical advice. Curalune does not allocate places and does not guarantee availability.