No rest for the elderly

An Auckland rest home has been forced to close following a Ministry of Health (MOH) inspection which found resident assessments were "poorly completed if at all," Consumer NZ can reveal.

Rathgar Court in Auckland has been closed after two inspections found the manager was unable to safely manage an aged care facility. However, it remained open for six months after the MOH inspection found major failings in care.

Reports released to Consumer under the Official Information Act show Rathgar Court was one of four homes inspected in the past year. Consumer NZ Chief Executive Sue Chetwin said shortfalls were identified at all four, but the most serious failings were at Rathgar Court. Ms Chetwin says most concerning is the fact consumers may know nothing about the seriousness of problems at a particular home because information about complaints is not routinely published.

"We've been pushing for details to be disclosed. So far we have had to make requests under the Official Information Act to get any detail about inspections resulting from complaints. Twice we have had to go to the Ombudsman," she said.

Rest homes are required by law to meet minimum healthcare standards. The ministry has the power to cancel their certification and close them, if they don't. They can also be prosecuted but these powers are rarely used and serious shortfalls - such as those at Rathgar Court - can continue for months. In that case the ministry inspected the home in November 2011 after allegations of physical and verbal abuse. The inspection couldn't find evidence of abuse but did find the manager and part-owner had no experience running a health facility and there was little "clinical oversight and staff management in place to ensure resident safety". Caregivers were unable to speak directly with a registered nurse after hours, and rarely saw the nurse at the facility.

The inspection found resident assessments were poorly completed if at all. A resident with dementia had signed his own statement setting out the treatment he wanted if he became unwell and family members were signing on behalf of other residents. The home was required to implement 17 corrective actions. However, a later full certification showed progress was unsatisfactory. A second allegation of abuse had been received and problems with management persisted.

In early May this year, the ministry told us the Waitemata District Health Board was monitoring the situation closely. However, by the end of the month the DHB decided improving standards were unachievable and transferred the 11 remaining residents to other homes.

The other homes to be inspected last year were:

Elizabeth R rest home in Stratford, which has been working with the local DHB to rectify problems. The home was inspected in October, following complaints that lack of staff over a weekend resulted in residents being left in urine-soaked beds. The inspection found the home was failing to fully meet all healthcare standards, and there was a lack of clinical experience in aged care.
Radius Maeroa Lodge which says corrective action plans have been implemented and there are no outstanding issues. Complaints there included quality of meals, room and water temperatures, hygiene and staffing.
Avonlea Hospital and Home which the ministry says required no corrective action. However, registered nurse cover is being monitored by the DHB.

Ms Chetwin says rest homes are responsible for caring for some of our most vulnerable citizens. Information on how well they do this should be in the public domain. "The ministry has finally agreed it will now publish full unannounced inspection reports on its website. We applaud that but more needs to be done," she said.

"Where rest homes consistently fail to remedy shortfalls, regulators need to use their powers to withdraw certification. The facilities should also face prosecution."

Consumer NZ would like to see mandatory reporting on key indicators of care such as:

Staffing ratios
Infection rates
Mobility
Pressure sores and weight loss

Rest homes receive considerable public funding. The minimum consumers should expect is that facilities falling short of required standards can be easily identified.
ends

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