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No vacuum and lack of food at rest home: staff

Author
Nicholas Jones, NZ Herald ,
Publish Date
Wed, 25 Apr 2018, 5:56am
The rest home changed hands late last year and shortly after a damning investigation. (Photo / File)
The rest home changed hands late last year and shortly after a damning investigation. (Photo / File)

No vacuum and lack of food at rest home: staff

Author
Nicholas Jones, NZ Herald ,
Publish Date
Wed, 25 Apr 2018, 5:56am

Food ran low at a rest home with no working vacuum cleaner and where incontinence supplies weren't available for "days and days", staff told inspectors.

The claims have been denied by the company that owned the facility at that time.

During an inspection last year, health officials noted a strong smell of faeces and urine in some areas of Wakefield Rest Home, south of Nelson. Wounds were untreated and a severely cognitively-impaired resident was self-administering angina spray.

The 22-bed facility sold shortly after a final report on the problems, and the DHB is satisfied the issues are sorted by the new owners.

Health officials made an unannounced visit the same day as receiving a complaint from a resident's family member last October 27, including about staffing cuts and volunteers calling around the community for food donations.

Notes from the visit, obtained by the Herald, outline how no facility manager or clinical manager was onsite, and it wasn't clear who was in charge.

In a quiet voice the cook reported many instances of insufficient food supplies, with stocks like marmalade and jam often running out. Staff brought in food and vegetables from home, the cook said. A fridge was opened to reveal one-and-a-half cabbages and a small amount of other food.

The officials met with a senior caregiver in charge of the 22-bed facility, who initially said care was "fine".

"Later in the discussion [redacted] said…'point blank, I am going to tell you'," the notes record. The caregiver went on to allege:

• Carpet in the room of a resident contaminated with faeces couldn't be cleaned as there wasn't carpet shampoo. A family member who wanted to clean out a birdcage couldn't as there was no working vacuum.

• There had been "days and days" without incontinence products. At other times staff were told to use only up to two pads a day, per resident.

• Staffing so low that there was no relief available if someone was sick or away.

Two more inspections were ordered after the screening visit, and a final report by Nelson Marlborough Health DHB produced on December 5 last year.

Twelve residents were assessed and had files reviewed. Ten had moderate or severe cognitive impairment, despite the clinical manager only identifying three residents with cognitive impairment.

A resident with severe cognitive impairment was self-managing a spray used to treat angina. This was of significant concern, given they had low blood pressure, and "there was no evidence of appropriate assessment or monitoring for safe self-medication".

Another resident with severe cognitive impairment had two open and weeping wounds on their leg, which the nurse manager didn't appear to have been informed about. Another resident had open wounds, with no wound care plan.

Some residents had conditions including heart failure or chronic obstructive airways disease, but didn't have a plan to monitor these conditions.

Interviewed caregivers said the "exploited" registered nurse was overworked and on call 24/7. One said it was "diabolical" there was only one registered nurse at the facility, and another felt bad asking for advice because of her workload.

A staffer said rostering had been cut to save money, and there was only one caregiver on during the weekend (contradicting provided rosters).

Shortly after the final report in December the rest home was sold by Manis Aged Care No 1, a company owned by Ashwin and Lowreen Mani. A provisional audit before the sale listed 15 corrective actions, two of which were high risk, and nine moderate.

Ashwin Mani, who still owns the Cameron Courts Resthome in Ashburton, said the allegations outlined in the DHB documents were completely false, and residents were well cared for.

Claims there wasn't enough food, limited access to incontinence supplies, no cleaner or working vacuum were wrong, Mani said, and he could prove weekly purchases.

"If those are in the media I am going to take this legally. Because this is not true. Why do you listen to staff, without coming to management for verification?"

Hilary Bird, new co-owner of Wakefield Rest Home, said a range of improvements had been made, including increased staffing, equipment and bringing fire sprinklers and alarms up to standard.

"I know they have food coming out of the cupboards, the incontinence products are all up to scratch. Families are a lot, lot happier. Carpets have been cleaned, windows have been cleaned."

Simone Newsham of Nelson Marlborough Health said it was satisfied all the issues relating to resident care had been addressed, and the older people in the facility were now well cared for.

"This has been verified by several follow-up visits with the new owners and we are closely monitoring and supporting the new owners to ensure the improved standard of care is maintained."

The Herald has reported on a number of problems at rest homes and alleged poor care.Consumer and health advocates are pressing Labour to act on policy held in opposition, including establishing an Aged Care Commissioner and updating voluntary aged care standards and making them mandatory.

A quarter of homes had medication shortfalls

Issues at Wakefield Rest Home concerning a resident left in charge of administering angina spray aren't isolated.

Nearly a quarter of all rest homes had a shortcoming related to medication management, a Herald review of more than 1000 audit reports released since 2016 for the country's 651 aged care facilities shows.

Problems found by auditors include wrong doses or unprescribed medications given, expired medication and a lack of documentation or GP review.

Medication trolleys were left unattended at several homes, and one had unsheathed needles connected to syringes. A blister pack of medicine was found with the original resident's name crossed out, and another name handwritten.

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