Rest home failed all its residents, ministry says

An investigation into the Wellington rest home at the centre of ill-treatment allegations has found it was failing all its residents.

Ministry of Health staff called a spot audit into the Malvina Major rest home on June 30, after The Dominion Post revealed shocking allegations regarding care.

In June, Susan Christian said her 69-year-old mother had received care that was disgusting and degrading.

Three times she found her stroke-stricken mother, who suffered from Alzheimer's disease, covered in her own faeces in Malvina Major Retirement Village hospital.

The ministry has now confirmed Mrs Christian's complaints against the rest home - and criticised the care given to all residents at the home owned by Ryman Healthcare.

"All complaints were substantiated, and Malvina Major Retirement Village is required to undertake the corrective actions," it says in an audit report.

Officials interviewed nine rest-home staff and reviewed clinical records of several residents, before concluding there was a "failure to fully comply" with eight health and disability services standards.

It found complaints often went unregistered, care plans were inadequate, there were breakdowns in communication between staff, and clinical leadership was not evident. The rest home had been given up to six months to make corrections, or further action would be taken.

Mrs Christian was relieved her complaints had been upheld, but shocked at the level of non-compliance. "I did not realise how huge it was. I am totally shocked but glad people have been made aware. I hope these types of places get audited more often."

Health Ministry officials found that the caregiver in charge of Mrs Christian's mother when she was found covered in her own faeces should have monitored her more closely. The incident had not been recorded in her file, a trend that was mirrored in a sample of other residents' files.

"There were inadequate instructions for staff to follow to ensure individual residents' care needs were appropriate," the report says.

When the clinical manager was questioned about her reactions to Mrs Christian's complaint, she said she had apologised and emailed two other managers.

Officials found the daily handover book had one line that read: "[Mrs Christian] has made a complaint about her mother".

Mrs Christian complained again the next day, after finding her mother in the same state. A change was finally made to the care plan, but this was left unmonitored for another day.

There were six reports of accidental falls in Mrs Christian's mother's file. Despite being identified as high risk, "strategies for minimising the risk of falls were not evident".

Statements about the falls by a registered nurse included comments that the 69-year-old Alzheimer's sufferer "lacked insight", the audit says.

Other residents' files had shortfalls in documentation, risk minimisation, and assessment. The rest home lacked an infection-control team.

Mrs Christian said Rymans were now "bending over backwards," and had reimbursed the family for about 12 weeks' fees for a $130-a-week "premium" room in the hospital. Under a new care plan, staff take her mother to the toilet every two hours, sign it off, check her hourly and no longer give her suppositories.

But Mrs Christian does her mother's washing, and she and other family members feed her dinner every night. "I am going to continue being there all the time, making sure those changes happen."

Ryman Healthcare NZ general manager Simon Challies said an acting manager and clinical services manager had been training staff and making changes at the rest home since the complaint.

The village manager had resigned voluntarily since the audit. "We accept the findings, because we identified some of the issues when we investigated the complaint ourselves . . . we were disappointed with what was found, it was mainly documentation issues and it wasn't good enough."

Ryman was making changes nationwide to incorporate more feedback from relatives and their residents.

Monitoring would be undertaken by the ministry and Capital & Coast District Health Board.

The board's executive director of service integration, Dr Ashley Bloomfield, said progress would be monitored stringently.

The Dominion Post