Footage from the camera revealed the man was bullied and intimidated by three separate carers at Iona Home & Hospital over several days.
A subsequent investigation by the Aged Care Commissioner has found widespread failures in the care of the man reflected ‘‘a culture of disrespect by caregivers at Presbyterian Support Otago (PSO) towards those under their care’’.
PSO owns and runs the rest home.
The camera was installed by the man’s daughters in 2019 after they became concerned that his aggressive behaviour since moving into care had become "completely out of character".
The video showed rest home staff shouting at the man, pointing angrily at him and failing to help him move or dress, despite his care plan requiring it.
The investigation found PSO failed to comply with legal, professional and ethical standards and in breach of the Code of Health and Disability Services Rights (the Code).
In the report released today, Aged Care Commissioner Carolyn Cooper found two caregivers breached the Code for failing to treat the man with respect and/or provide services of an appropriate standard.
A third caregiver breached the Code for failing to intervene or report the abusive behaviour.
The man had moved into the dementia unit, as his wife was no longer able to care for him at home.
In addition to his progressing dementia, the man had several other medical conditions.
His care plan indicated that he needed significant assistance with activities of daily living, such as mobility and personal care.
The report said prior to the complaint about his treatment, incidents of aggression by the man were reported by two caregivers and his family was informed. The family expressed concerns that staff might be contributing to the man’s behaviour and installed the camera in his room.
‘‘The conduct displayed by the caregivers towards the resident, as seen in the video footage, is never acceptable,’’ Ms Cooper said.
A lack of action by one caregiver also breached the Code.
‘‘It’s disappointing that she did not speak up or intervene during the inappropriate behaviour towards the man.’’
The report says it is clear, following review of the video footage, that three caregivers did not provide appropriate loving care to the resident.
The family raised its complaint with PSO, which investigated and confirmed the behaviour was not in line with the organisation’s standards and that it had failed to ensure the man’s safety.
The report highlighted issues with workplace culture that contributed to the breaches of the Code, including staff being overworked and not empowered to report inappropriate behaviour and a lack of proper oversight and support.
‘‘In my view, the widespread and repeated nature of these actions by caregivers at PSO reflects a pattern of poor care and a failure to comply with policy and legal standards, for which ultimately PSO is responsible,’’ said Ms Cooper.
‘‘PSO had a responsibility to prevent issues of abuse through appropriate selection of staff, training, rostering, oversight, and performance monitoring.’’
The report also highlighted issues with care planning, resourcing limitations and delay in investigating the incidents relating to behaviour of the man.
It outlined multiple changes PSO has made to improve staff training, culture and care practices and recommends further action including that the involved staff apologise directly to the family involved and the PSO continue to provide evidence of ongoing training, education and support for staff.
PSO responds
Responding to today's report, PSO chief executive Robbie Moginie said the case was devastating for all concerned but most of all for the resident and his family.
"[They] experienced a level of disrespect and harm that fell well short of the standard of care PSO residents and community deserve and have come to expect from our Enliven services."
A significant internal investigation led to changes in the way PSO trained and monitored staff and in its rostering and induction processes.
Asked how confident PSO was there was no longer a "culture of disrespect" by caregivers at PSO towards residents, she said PSO had taken "very seriously" the fact that staff at the time felt they could not report issues that were going on.
It had worked hard to create a speaking-up culture in which residents, their families and staff could easily raise any concern and know it would be listened to and acted on.
"We know that with changes in staff it is critical that we continuously reinforce this."
PSO was fully confident the vast majority of its staff "had never and would never" bully a resident, she said.
"This case was an exception at the time but our systems of speaking up, monitoring and reporting needed improvement."
Significant changes made since included that PSO internally monitored residents' experience and satisfaction, held resident meetings in which feedback and concerns were invited, and followed through on any concerns raised by staff, residents and their whanau as standard practice.
The organisation had noticed a difference in confidence to report issues between staff born in NZ and international staff and it had implemented an extensive organisation-wide education programme.
The staff member most seriously implicated in the 2019 case no longer worked for PSO, Ms Moginie said.
- APL
