Director of Proceedings v Oceania Care Company Limited [2022] NZHRRT 8 (25 February 2022)
The Director filed proceedings by consent against Oceania Care Company Ltd (“Oceania”) in the Human Rights Review Tribunal, regarding the care Oceania provided to Mr A, an elderly resident in one of the rest homes it owns and operates (“the Rest Home”).
At the time of Mr A’s admission to the Rest Home he was aged 80 years and had T4 paraplegia,[1] frontal lobe dementia,[2] and chronically low blood pressure. To assist with the management of his continence, Mr A had both a suprapubic catheter[3] and a colostomy.[4] Prior to Mr A’s admission to the Rest Home, his wife had been his primary caregiver, and together they had managed his paraplegia for 26 years with relatively little help. During Mr A’s admission to the Rest Home, he developed serious pressure wounds, and required hospitalisation for urinary tract infections. He died approximately six months after admission to the Rest Home.
The New Zealand Health and Disability Services Standards require rest homes to ensure that their services are managed in an efficient and effective manner, to ensure the provision of timely and safe services to consumers. Oceania accepted that it had a duty to provide residents in its facilities with services of an appropriate standard, and that as the service provider and employer of staff at the Rest Home, it had primary responsibility at a systems level for the poor standard of care provided to Mr A by the multiple staff involved in his care. Oceania acknowledged that there were deficiencies in the care provided to Mr A, and there was a failure to put in place effective actions to prevent and manage Mr A’s serious pressure injuries and infections. In particular, Oceania accepted that it failed to provide Mr A with an appropriate standard of care, and therefore breached Right 4(1) of the Code[5] for the following reasons:
- The assessment of, and care planning for, Mr A were inadequate. In particular, there was a lack of initial consultation with his wife, an interRAI assessment was not completed in a timely manner, and there was a lack of documented assessment of his pressure-injury risk or plans to mitigate that risk.
- Documentation and evaluation of wound progress were lacking, and the notification to HealthCERT of Mr A’s buttock wound was inaccurate and delayed.
- Fluid balance monitoring was not completed from the outset, despite Mr A having a suprapubic catheter in place, which put him at risk for developing an infection.
- There was a failure by multiple staff to follow Oceania’s policies and procedures. In particular: an unapproved restraint (a reclining arm chair) was used in contravention of Oceania’s policy and without suitable provision of pressure relief; Mr A’s long-term person-centred care plan was not completed within the specified timeframe; and fluid balance documentation charts were not completed adequately.
The matter proceeded by way of an agreed summary of facts. The Tribunal was satisfied that Oceania failed in the care that it provided to Mr A, and issued a declaration that Oceania breached Right 4(1) of the Code.
The Tribunal’s full decision can be found at:
[1] Loss of ability to use the legs owing to damage to the spinal nerves, which had been caused by an accident 26 years previously.
[2] A type of dementia connected with shrinkage of the frontal lobes of the brain.
[3] An artificial flexible tube used to drain urine directly out of the bladder.
[4] A surgical procedure that brings one end of the large intestine out through the abdominal wall. This allows faeces to leave the body through an artificial hole in the skin and into a pouch attached to the patient.
[5] Right 4(1) states: “Every consumer has the right to have services provided with reasonable care and skill.”