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Standard of care in an aged care hospital (08HDC15931)

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(08HDC15931, 31 August 2009)

Aged care facility ~ Registered nurse ~ Facility manager ~ Hospital-level aged care ~ Standard of care ~ Complaint processes ~ Cooperation among providers ~ Clinical governance and quality systems ~ Rights 4(1), 4(3), 4(4)

The family of an 84-year-old man complained about the care he received in a home and hospital. He was initially admitted to the dementia unit, but some years later his health declined and he was transferred to the hospital section. The man's daughter alleged that during the time her father was in the hospital, he received inadequate nourishment, which resulted in rapid loss of weight (8kg in 10 days), he developed pressure sores on his buttocks and heels, and a chest infection that was not diagnosed by hospital staff. His hygiene and personal needs were not adequately managed, and he was neglected, left alone and unturned for long periods. She was also concerned that he was chemically restrained (sedated). The man died a few months after he was transferred to the hospital section. The post-mortem report noted that at the time of his death, the man had advanced pulmonary disease and had abnormally low weight, weakness and general bodily decline.

It was held that the home and hospital failed to provide the man with reasonable care and services that met his needs and optimised his quality of life, by failing to provide adequate systems and adequate support for senior nursing staff, and therefore breached Rights 4(1), 4(3) and 4(4).

The facility manager, although not directly responsible for the provision of care, failed to ensure that the man was provided with reasonable care, breaching Right 4(1) of the Code.

Other registered nurses involved in the man's care were not found in breach of the Code, although some adverse comment was made with regard to disrespectful comments and the handling of complaints made by the family.