Older Woman's Rights Breached By Care Home Provider 21HDC02752

An older woman’s rights under the Code of Health and Disability Services Consumer’s Rights (the Code) have been breached by Presbyterian Support Southland, the Aged Care Commissioner has found.

In a decision released today, Carolyn Cooper found the service did not provide an appropriate standard of care to the woman who had multiple long term and complex conditions while she was under its care between July and September 2021.

The woman had been living in an independent cottage within the complex but a fall and injury, resulting in a stay in hospital, necessitated her move into the facility’s hospital level care.

The woman had congestive heart failure which required oxygen therapy and compression stockings to manage fluid retention in her legs. Her hospital discharge notes recommended she was to be weighed daily and have her fluid intake restricted to help manage the swelling.

Ms Cooper said the service breached the woman’s rights by not including baseline vital observations, such as her oxygen saturation, which would have informed staff about when to escalate her care. She noted poor documentation of the woman’s fluid balance records, and that she was not weighed regularly, nor was there guidance on managing her fluid intake.

"There was no guidance in Ms B’s initial care plan on how to apply, position and remove her compression stockings, nor was there evidence of pain assessment forms and limited documentation of the effects of her pain medication," she said.

Ms Cooper made a range of recommendations which included a formal apology from Presbyterian Support to the woman’s family, as the woman has since died. Additionally, she recommended that it review its oxygen management and nutrition and hydration policies with a focus on education and staff training, provide HDC with evidence of training for staff on applying and appropriate use of compression stockings, and of evidence of staff training on privacy, infection control and nursing assessment and care plans. Finally, she recommended it consider putting in place better processes to ensure residents’ needs are met in a timelier manner.

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