3 Aug 2017

Care home complaint becomes consumer case

From Nine To Noon, 9:09 am on 3 August 2017

A man who claims a resthome failed to provide basic care to his mother is heading to the Disputes Tribunal after the usual process proved "slow, painful and likely fruitless".

Robert Love says documented events at St Kilda resthome in Cambridge reveal successive occasions when his mother Freda, who has since died, failed to receive basic nursing care.

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Photo: 123rf

His complaints include that he paid for enhanced services were not provided, that his mother was frequently kept in conditions that were too hot, and that on 10 separate, documented occasions her catheter was "yanked from her leg", leaving her in a urine-soaked bed.

"My mother came to Bupa St Kilda with an in-dwelling catheter... Management of that is a basic nursing deliverable but Bupa didn't have the skill or the competence to be able to manage that," he told Nine to Noon. 

"So it's been ripped off of her leg, out of her bladder, so she's leaking into her bed and many hours may have elapsed before that was discovered," he said.

"Frequently through the months of November and December last year the temperature exceeded 30°C - that's documented - and the humidity was very, very high. 

"And under those conditions you start to see a deterioration of skin condition. Bupa would not address that problem, they refused to address that problem." 

He had to buy an air conditioning unit for the room, but because of the room's design and insufficient ventilation - and despite it running full time - the unit was unable to keep up with the heat. 

St Kilda was also a hospital-level care unit, he said, requiring at least two people to operate a hoist, which was something that his mother required. 

However, her section had mainly residents who could walk, so only one staff member was employed per 10 residents. They had to find a second person to hoist his mother, leading to long delays. 

He was living on superannuation himself but still paid an extra $52 a night for a premium room for his mother because there was no other room available when he approached Bupa. 

"We negotiated at that time that when a less expensive room might become available I would have an option to move my mother to that room. That other, cheaper room never became available."

When asked for comment, Bupa released a written statement. 

"Bupa regrets any distress Mrs Love endured and apologises unreservedly to the family. The care of our residents is our highest priority, and we treat these matters very seriously," it said. 

"This matter is currently subject to a tribunal hearing, therefore we can't comment in detail at this point in time. 

"We do however wish to stress that the well-being of our residents and their families is at the centre of our being as a business, and as such we have reflected on these matters at length. 

"We continue to make efforts to contact Mr Love through the Health and Disability Advocacy service to try and resolve the issues he has raised."

Years of problems across the industry - Consumer NZ

Consumer NZ Head of Research Jessica Wilson said the organisation had taken an interest in the case, having reported on rest home complaints since 2009. 

"And today we're still seeing the same sorts of complaints coming up ... like Robert's, that a family member is not receiving the standard of care that you would expect."

At the core of the complaints was inadequate staffing, both in numbers and training, she said.

Consumer NZ had been calling for some time for a broader inquiry into rest home funding and standards. 

"Sometimes a rest home can have a clean audit report, looks good, everything's fine, then we get a compaint, an unannounced inspection by the Ministry of Health which uncovers problems that weren't picked up in the audit." 

The findings from international research showed care at not-for-profit homes tended to be better than for-profit homes.

"So I think we are definitely at a point where we need to look at how we're going to fund the sector."

One option would be to have the Ministry of Health actually employ the staff at such homes, she said.  

[h] A 'fruitless' complaints process

With not enough money to seek redress through higher courts, Mr Love is taking the unusual step of claiming a breach of contract at the Disputes Tribunal.

He had tried contacting the Ministry of Health and Waikato DHB over the problem with temperatures in his mother's room, and involved a health and disability advocate.

However, these more usual processes had proved a "slow, painful and likely fruitless process''.

"What I'm hoping to do with the disputes tribunal is to establish that rest homes can't with impunity behave the way that Bupa has behaved, that there is a consequence - a financial consequence," he said.

"Clearly they don't change when it takes months, sometimes years, for a report to be made available, which is really something much like a wet bus ticket being slapped on the back of your hand."

Such a report would not identify which rest home had erred, and that was a useless piece of information from a consumer's point of view, he said.

Although they were required to respond to complaints within a certain timeframe, such complaints to the rest home had also been unsuccessful, he said. 

"They tend to form a pro-forma type response in which they set out my complaint back to me ... sometimes they acknowledge that and say yes, the learning outcomes have been shared, and that would be the end of it."

Some responses also failed to arrive before their deadline, and sometimes did not arrive at all.

Ms Wilson said the Disputes Tribunal was also limited, however.

"It's an option where you have out-of-pocket expenses as a result of your contract with a rest home," she said. 

"In Robert's case, he was paying an extra $52 a day, he spent extra to buy the air conditioning equipment, but it is limited in what it can provide and it isn't precedent-setting." 

The office of the Health and Disability Commissioner declined to comment, with deputy commissioner Rose Wall saying she was unable to because of the privacy of the parties involved. 

There was possibly still an active case before the office.