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Care of disabled man receiving individualised funding (13HDC00854)
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Disability service provider ~ Support worker ~
Individualised funding ~ Informal arrangement ~ Care planning ~
Record keeping ~ Quality monitoring ~ NZS 8158:2003 standards ~
A woman complained about the care provided to her 20-year-old
son, who had complex needs and required one-to-one care. Since
2003, the woman had chosen her son's support workers and had a
longstanding professional relationship with one support worker and
his family members who became the young man's support workers. Care
was usually provided in the support worker's family home.
In 2011, the young man's needs assessment service coordinator
(NASC) referred him to an individualised funding (IF) host
provider. The mother became her son's IF agent. The IF host
provider's role was to help the mother to understand IF, and how to
organise, set up and manage the young man's support allocations and
administer payments for support services, and to help the mother to
manage her responsibilities. The IF host provider was required to
carry out quality monitoring at six-monthly intervals.
The mother continued to use the support worker's family as the
young man's main support workers, and privately engaged an agency
to help manage the support package. There was no written contract
between the agency and the mother.
In 2012, the main support worker went on leave. The support
worker's son (the second support worker) became one of the young
man's support workers at this time. He was an independent
contractor of the agency and was also the support worker for
another client. He gained his experience as a support worker for
the man when assisting his father to care for the young man for
approximately one year several years prior. Prior to working with
the young man in 2012, the only training provided to him by the
agency was a first aid course.
On one particular day, the second support worker was rostered to
care for the young man and another client on the same day. However,
the agency understood that another family member of the main
support worker would be looking after the young man, and that the
support worker would be looking after the other client only.
The second support worker proceeded to care for both clients at
the same time, as well as his own young child. In the evening, he
left both clients unsupervised and locked in his home while he went
to collect food. A fire broke out and the young man was unable to
get out of the house and, sadly, died in the fire.
It was held that the second support worker did not provide
services with reasonable care and skill and breached Right 4(1) by
caring for three vulnerable people at one time when he knew the
young man required one-to-one care, and by leaving the young man
unsupervised and locked in his home with another client, despite
knowing that the young man must always be supervised.
The agency failed to provide services consistent with certain
NZS 8158:2003 standards and breached Right 4(1) of the Code by
failing to adequately assess or monitor the quality of care being
provided by the second support worker; failing to provide training
or supervision to the second support worker in caring for clients
with the young man's needs; and failing to have a formal written
agreement in place with the mother which resulted in uncertainty
about the roles and responsibilities of those managing the young
man's support. In addition, the process for rostering support
workers created an environment where errors could occur and the
agency did not conduct the necessary checks to ensure that the
young man would be receiving one-to-one care by a suitably
qualified support worker when it realised that it had rostered one
support worker to work with two clients on the same day. The
agency's care planning and record-keeping was suboptimal.
Adverse comment is made about the IF host provider's quality
monitoring. The NASC did not breach the Code.
The second support worker and the agency were referred to the
Director of Proceedings for the purpose of deciding whether any
proceedings should be taken. The Director did not institute
proceedings against the agency. The matter was resolved by way of a
negotiated settlement. The Director filed proceedings by consent
against the support worker in the Human Rights Review Tribunal. The
Tribunal issued a declaration that the support worker breached
Right 4(1) by failing to provide services with reasonable
care and skill.