A home care provider has been found in breach of the Health and Disability Code after failing in its care of a woman with a skin condition.
Opportunities were missed for a woman to get the clinical care she needed, the deputy health and disability commissioner says. (file pic) Photo: 123RF
She later died as a result of a bacterial skin infection.
The woman in her 60s suffered from health conditions including a history of skin infections and had not left her house in over a year.
Access Community Health Limited workers raised concerns over her deteriorating skin several times in the months before her death, but they were never escalated or actioned.
Deputy Health And Disability Commissioner Rose Wall said the failure contributed to the worsening skin condition.
"These service failures contributed to a delay in her receiving a review of her deteriorating skin condition, and opportunities were missed for her to receive the clinical care and intervention she needed," Wall said.
"This case highlights the importance of coordination by all health service providers involved in a consumer's care, that their respective roles and responsibilities are understood clearly, communication channels work effectively, and they are responsive to the person's changing needs.
"This is particularly important in situations where the consumer has co-morbidities and is at risk of becoming seriously unwell over a short timeframe."
Wall was critical of the clinical nurse manager, who did not address the health concerns escalated from support workers, and did not make clinical notes in the woman's file.
Wall recommended that Access:
- Review its system for monitoring comprehensive reports
- Review the training provided on responding to support workers' reports
- Undertake a nationwide audit against documentation policies and standards
- Review the training provided on documentation
- Provide a written apology to the woman's family
She also recommended that the clinical nurse manager:
- Report to the HDC on her reflections and the changes to her practice as a result of this case
- Undergo further education on the subject of documentation
- Provide a written apology to the woman's family