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Source: MIL-OSI Submissions

Source: Health and Disability Commissioner

Deputy Health and Disability Commissioner Rose Wall today released a report finding a healthcare trust, operating a rest home, in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to respect the dignity and independence of a rest home resident.
The woman was a full-time resident of the rest home, and required hospital-level care. She had a complex medical history which included vascular dementia. Previously, she had been living at home with her husband.
She became wheelchair-bound and bed-bound, and was reliant on staff for cares. Over the course of two months, the woman had a number of falls. The following year, the woman’s granddaughter placed a hidden camera in the woman’s room. Video footage recorded by the camera showed a number of healthcare assistants (HCAs) providing cares to the woman, including showering, toileting, dressing, and feeding her.
The footage provided to HDC showed the woman being treated roughly by staff, and appearing distressed. The woman was rarely acknowledged or spoken to by the HCAs, and there was little indication that cares were explained to the woman before they were carried out, as her care plan indicated they should have been. In one video, an HCA is seen using her mobile phone in front of the woman while the woman was nude from the waist down.
Deputy Commissioner Rose Wall considered that the footage painted a troubling and disappointing picture of the care provided to the woman by the HCAs, that fell well below the expected standard. In the Deputy Commissioner’s view, the number of HCAs involved suggested that staff did not understand what was expected, as there was a pattern of behaviour that failed to respect the woman’s dignity and independence.
The Deputy Commissioner considered that the trust failed to provide sufficient oversight, and ultimately was responsible for the issues. The widespread failures were found to reflect a pattern of poor compliance with policy and a widespread culture at the rest home that lacked compassion and concern for the woman’s dignity and independence.
Ms Wall was also critical of some aspects of the trust’s management of the woman’s falls risk, and that neurological observations were not carried out following all unwitnessed falls.
“The right to be treated with respect and dignity applies to all consumers universally,” said Ms Wall. “However, where a consumer is vulnerable and less able to advocate for their own interests, providers need to be particularly sensitive to the need to treat that consumer with respect and ensure that services are provided in a manner that respects their dignity.”
Ms Wall recommended that the trust review the systems currently in place in its facilities for monitoring the interactions between staff and residents; develop a dedicated policy for communicating with residents who have advanced dementia, and provide training to staff on the new policy. She also recommended the trust undertake a random audit of 20 incident reports for resident falls, to ensure that neurological observations are being completed for all unwitnessed falls.
Ms Wall recommended that the trust consider amending its moving and handling policy to include guidance on when a resident is rigid or difficult to transfer, and that it provide an apology to the woman’s family.
The Deputy Commissioner referred the trust to the Director of Proceedings.
The full report for case 18HDC00859 can be found on the HDC website.

MIL OSI