Fewer than one in 10 rest homes is meeting all mandatory health care requirements, according to an audit of Ministry of Health reports by Consumer New Zealand.
Of the 634 homes reviewed, 28 per cent of facilities had minor shortfalls; 61 per cent had more-than-minor shortfalls; and 3 per cent had major shortfalls.
Only 57 met or exceeded all criteria. The highest rate of failure was in criteria that ensured residents' needs were assessed and they got appropriate care - what Consumer called "the basics of what a rest home is supposed to do".
The Consumer review also identified a number of rest homes that have had recurring problems, dating back years in some cases.
It found limited improvements made in the sector since a damning report in 2009 by Auditor-General Lyn Provost which was critical of rest-home monitoring. Provost found existing procedures did not provide adequate assurance that homes met the required standards of care.
"The ministry has implemented changes and there are signs audit processes are improving. But the same assurance can't be given about quality of care, despite the industry receiving over $900 million a year in public funding," said Consumer researcher Jessica Wilson.
Wilson was also critical of the Ministry of Health policy in publishing reports on rest homes. The ministry does not routinely publish full reports, only issuing summaries. It also did not keep historic records of reports in the public domain, preferring a "clean slate" policy - publishing results each time a home was inspected. Wilson said that made it difficult for the public to tell whether a rest home had a history of failings.
She said people should have access to the full audit and for previous reports to remain available.
"There is still not enough good information coming out for consumers to get a good idea of what is happening in a home. It seems very strange when this is a core public health service," said Wilson.
For such a significant decision about the lives of often vulnerable people, access to better information was needed, she said.
"You are often making it at a time of stress, so you should have good information in front of you to make that decision."
She also said low staffing was a recurring issue across the sector which needed addressing - one rest home had rostered staff hours that were 70 hours below the minimum recommended for safe care.
Wilson said mandatory staff-to-resident ratios were needed. Human Rights Commissioner Judy McGregor made the same recommendation in a 2012 report on aged care.
The government has so far rejected this recommendation, instead introducing a new clinical assessment tool intended to provide better information about residents' care. It will measure indicators such as infection rates, mobility and weight loss. It is scheduled to be in place by July 2015.
- © Fairfax NZ News