Christchurch rest home slated for inadequate care

Inadequate staffing and governance at a Christchurch rest home led to a lack of care, deteriorating health and sometimes squalid conditions for two of its patients, reports show.

The Health and Disability Commissioner reports released today followed complaints from the families of patients at Villa Gardens Home and Hospital in Addington.

One of the patients was found to have not showered for more than a year.

Two staff and the home's owner, Oceania Care Company (previously Eldercare), have been censured for breaches of the Code of Health and Disability Services Consumers' Rights.

Deputy Commissioner Rae Lamb said improvements had been made over the past year, but a toxic work environment and lack of resources contributed to the situation.

The first patient, referred to as Mrs A, was transferred to the dementia unit a few years after moving into Villa Gardens.

She had been known to refuse to wash or take medication, but in July 2007, her family became concerned about her physical, mental and emotional condition and made several complaints to the home's management.

Her family said at one stage they found soiled underwear and towels in her drawers and dirty dishes with days old food on them stashed throughout her unit.

The woman was later assessed by a psychiatrist and it was revealed she hadn't had a shower in over a year and had taken only about 75 percent of her prescribed anti-psychotic treatment.

Disagreements between the family and staff compounded the problems.

The report said a facility manager was appointed in 2007 to the home, and identified what she considered a difficult work environment and dysfunctional relationship between the care manager and nurses.

The care manager resigned in May 2008, and the report suggested the relationship between her and the facility manager was also tense.

A Canterbury District Health Board (DHB) audit in July found there were staffing shortages and inferior systems and processes.

The facility manager assisted with the audit but did not return to work afterwards.

Similar issues were also brought to light through complaints around the same time involving the home's care of a man in his 80s.

His physical condition quickly deteriorated when he was moved from the dementia unit to the hospital wing in April 2008 .

His weight plummeted to 47kg and a family member reported finding him slumped in a chair with a dirty nebuliser left running in the face mask on the floor, in a room scattered with personal items.

The man died in August 2008, while the woman ended up being moved to the psychogeriatric ward at the public hospital.

Ms Lamb said Villa Gardens had substandard systems available in 2007 and failed to sort out tensions among nursing management.

Villa Gardens and Oceania Care Company were therefore vicariously liable for the breaches of the code.

The reports also outlined failures by the facility manager -- in the case of both patients -- and the care manager in relation to Mrs A, to carry out their responsibilities adequately.

Despite difficulties, both had to bear some responsibility for the care lapses and had therefore breached the code.

Censures included written apologies from the facility manager to the families -- something the care manager had already done in regard to Mrs A -- and a recommendation the care manager review her practice and advise of changes implemented.

Oceania also apologised and was requested to review the progress made in updating its policies and procedures, upskilling staff and management, and report back to the commissioner.

The reports said there had been structural changes at the home since the issues were raised, and ongoing DHB audits were finding systems improving.

- NZPA