The client said he drank alcohol and smoked marijuana with the caregiver, who supplied him with these substances and would film him smoking on his phone (file image). Photo: 123rf
A caregiver accused of supplying an intellectually disabled client with marijuana and alcohol, using him as "a punching bag", and sharing videos of embarrassing acts has been criticised by the health watchdog.
In a just-released decision, the Health and Disability Commission also found the disability service provider breached its vulnerable client's rights by failing to properly act on his complaints.
The residential care facility, which was run by a charitable trust, lost its contract with the Ministry of Health after an audit in 2021, but may face further legal action.
Deputy Health and Disability Commissioner Rose Wall said there was "public interest" in holding the service and the care worker to account for their many failures.
Deputy Health and Disability Commissioner Rose Wall. Photo: Supplied
The resident - a man in his 30s at the time - and the carer had known each other for around 20 years. But in October 2020, he first told his psychologist that he did not "feel safe" around the caregiver and the clinician helped him complain to the provider.
Due to "longstanding memory difficulties", the man was not able to provide the HDC with exact dates of the incidents but estimated that they all had occurred between January 2020 and January 2021.
The caregiver told investigators the pair "maintained a friendship, they were close like brothers, and they had known each other since they were kids".
He characterised various violence incidents described by the other man as "play fighting" or "mucking around".
The client - referred to only as Mr A in the report - said he drank alcohol and smoked marijuana with the caregiver, who supplied him with these substances and would film him smoking on his phone.
An ex-staff member told investigators that Mr A had told him the same thing and that on two occasions, bags of marijuana had been found at the property.
The carer told investigators he had only consumed marijuana with Mr A once in his teens, prior to his employment at the disability service.
Mr A also disclosed several violent incidents, including at a gym boxing class, in which the caregiver treated him "like a punching bag", hitting him in the nose and face several times and filming him.
The caregiver conceded he could have hurt Mr A "a little" because of the nature of boxing, but he was adamant that he was not too hard on him "because he was aware of his disability".
Mr A accused the other man of strangling him on two occasions and also referred to an incident in which he was thrown against the wall of a garage after they had both been drinking.
The disability service told the HDC that it investigated an incident in 2019 at a gym when the caregiver was not on shift involving him making fun of the disabled man in front of his friends.
It dealt with the incident "verbally" and told him not to attend the gym with the client again.
The provider said when it asked the caregiver about a "choke hold" incident, he explained they had been play fighting but he could not remember putting his hands around the neck of the disabled man.
Management told the caregiver to apologise for scaring the man, but the HDC noted there was no record of the incident.
In March 2020, the resident was burning rubbish in a field when the caregiver threw a piece of wood at him, hitting him on the leg.
The caregiver accused the resident of throwing a pair of secateurs towards his feet, and said the incident report cleared him of wrongdoing.
The client also accused the caregiver of showing him pornography on his phone and a video of another resident at the disability service being made to put a sex toy into his mouth whilst being laughed at by the caregiver and his friends.
The caregiver told the HDC this incident had been dealt with "in house".
The provider said when it questioned the caregiver, he explained the toy was in fact melted chocolate bars given to the other client by a barber, and the video had since been deleted.
Mr A had also said he did not feel safe being driven by the caregiver, who admitted his driving was "occasionally fast", and he often moved in and out of traffic as he did not like sitting in queues.
Breach
In her final decision, Wall said Mr A's allegations about the care worker's behaviour were "very serious".
"However, it is difficult to verify either version of events. I am unable to make a finding on all incidents, as described by Mr A, because of the at times conflicting information provided by each party. Any ability to make findings of fact is also hampered by the disability service's lack of independent investigation and contemporaneous documentation of these concerns."
There was enough evidence however to conclude the care worker acted inappropriately, she said.
"There was a clear power imbalance and the caregiver failed to maintain the professional boundaries required of him in his role as a carer," she said.
She found that "by consuming alcohol with Mr A, being violent towards him, and driving in a way that made him feel unsafe, Mr B failed to provide services with reasonable care and skill".
Wall was also critical of the way in which the service managed the resident - and care worker's - complaints, noting it was important that vulnerable consumers, especially those in residential settings, had their complaints and concerns taken seriously and managed appropriately.
While the service was no longer operating, Wall recommended a trustee, or senior staff member employed at the time of the events, formally apologise to the man.