Chief Ombudsman Releases Report Into Secure Aged Care Facilities

The Chief Ombudsman Peter Boshier is concerned that people can be placed in secure aged care facilities in New Zealand without the proper legal authority.

Mr Boshier has today released a report on his inspections and visits to 148 secure residential aged care facilities across the country from 2021-2024.

"The COVID-19 pandemic saw many restrictions imposed in these types of facilities. As part of my regular visiting programme I wanted to check whether these restrictions had been lifted or at least minimised. I am pleased to say that most of the restrictions I saw during the pandemic had been lifted.

"I also identified some areas that need to be addressed, including the lack of independent and centralised oversight around the legal basis for a person’s placement in secure care.

"In the vast majority of facilities I found that at least one resident didn’t have a legal basis for being placed there and at a small number of facilities, almost half of the residents didn’t have the proper paperwork.

"I have observed varying levels of understanding on the part of facility management, medical professionals, and whānau around what is legally required and why it is required for someone to be placed in a secure aged care facility.

"I consider there would be significant benefit in establishing a centralised register for Enduring Power of Attorney to help with these issues."

Mr Boshier says a number of other improvements could be made including in the area of restraint.

"It alarmed me to find that restraint policies were not always followed.

"Restraint comes in many forms, including staff using their own body to limit residents’ movement, using equipment to limit residents’ movement, and locking doors to prevent free movement between different areas.

"Residents receiving psychogeriatric care are at increased risk of being subjected to excessive restrictions or restraint.

"In many instances it was clear that staff did not fully understand how certain actions result in residents being restrained, for example, restraint applies to residents who are left in recliner chairs with their legs elevated, where they are clearly unable to move from that position."

Mr Boshier also identified issues around the treatment of residents with dementia.

"I was very concerned that a small minority of facility staff and management felt that because residents had dementia they were not capable of making complaints.

"Residents are the experts on their experience of care. All residents have the right to share their opinions and be heard. They need ways to let someone know if they feel unsafe or they are dissatisfied with their care."

Other issues Mr Boshier found were an over-reliance on whānau to provide advocacy and support for residents, resourcing pressures across most facilities and staff who were close to burnout.

"I am pleased, however, to see a range of improvements have been made by a number of the facilities I visited. These are still happening and I encourage all facilities to continue making improvements. I wish to acknowledge the commitment shown by staff I met and observed to delivering the best treatment and conditions to people living in secure aged care facilities.

"It is vital that the human rights of all residents in our country’s secure aged care facilities are safeguarded and maintained."

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