More issues have been uncovered at a Waikato rest home, despite last year being fined for failing to provide proper care to a 92-year-old woman.
Six failings were discovered by Waikato District Health Board staff during an unannounced visit to St Kilda Care Home in Cambridge in June.
St Kilda is owned by Bupa Care Services, a major provider of rest-home care in New Zealand, and this morning "sincerely apologised" for letting its residents down.
Consumer NZ head of research Jessica Wilson said at the time of the inspection, the home was only fully meeting four of seven criteria that were assessed.
The inspection found staff failed to respond to call bells within the home's expected three-minute time frame, with some call bells left unanswered for more than 20 minutes and care-planning standards varied among staff.
"There were two instances where no plans were in place to treat residents' medical needs. Four out of 12 long-term care plans had not been evaluated within the expected six-month time frame."
Corrective action plans weren't in place to address improvements required following complaints and there was a lack of evidence to show residents' family members were involved in care planning.
Wilson said further training of staff was also needed as the company's "wound nurse champion" had not received adequate instruction.
The inspection came seven months after the Disputes Tribunal found the home breached its obligations to provide services with reasonable care and skill to 92-year-old Freda Love.
Bupa was ordered to pay $10,000 to her son, Robert Love, who took the case to the tribunal.
On one visit to the home, Love arrived to find his mother shivering under a thin blanket in a urine-soaked bed. Her room was cold, the window wide open and the call bell out of her reach.
As a result, Bupa St Kilda has been ordered to carry out a raft of remedies including ensuring all registered nurses undertake care-plan training and that regular internal audits of care plans occur and ensure call-bell data is used for quality-improvement processes.
Robert Love said he had concerns about how the Waikato District Health Board (DHB) had dealt with ongoing problems at the care home.
He believed that the WDHB had tried to "whitewash the findings from the audit" in a letter he received from them in July.
"Astonishingly the DHB letter informed us that the above audit 'had not found that the issues I had complained about in 2017 were on-going or that current residents were at risk or that care was not safe'," he said.
"It further described the failures as a 'breach of contracted services which are determined as correctable by the facility without additional input by the DHB'.
"These are remarkable statements given the number and nature of the failures discovered by this unannounced audit and should raise questions regarding the relationship this regulating authority has with a provider when such obvious evidenced based concerns arise."
Love said it was essential that corrective actions be comprehensive at Bupa St Kilda.
"Given the type of failings and problems the audit uncovered, there is a real potential for these to translate into a dangerous cocktail of misadventure and neglect.
"The DHB should now urgently assess how extensive and deep the problems are at Bupa St Kilda. This can only be achieved with additional, wider focused unannounced audits.
"To do anything less is to deny the evidence at hand while failing to act in the interests of the vulnerable residents at Bupa St Kilda."
Carolyn Cooper, chief operating officer and lead nurse for Bupa Villages and Aged Care New Zealand, accepted they had more work to do and the company was keen to improve its services.
"We sincerely apologise again to the residents and relatives of Bupa St Kilda care home. We pride ourselves on our person-first approach to aged care and know the responsibility that comes with caring for older New Zealanders."
She said they took the findings "extremely seriously" and had taken further action to continue to improve quality at the care home.
"A follow up audit by an independent reviewer at the end of June found that there was no evidence of the historical complaints of poor care that had been provided to the auditor.
"We know there is more to do but we are responding to this with the utmost seriousness and desire to improve."
She added that the three failings were rated "low to moderate risk" by the auditor and were also carrying out random audits of call bell response times.
Waikato DHB spokeswoman Lydia Aydon said they commissioned the audit to see if the issues raised in Love's case were ongoing.
"The auditors determined that the specific issues were not recurring, but findings signalled areas for quality improvements in three specific areas of the contracted care services."
The three issues were; not meeting call-bell response times, timely review and updating of care plans and ensuring there is a robust internal and external training programme around wound care.