A caregiver allegedly put her hands around the throat of a frail patient, a woman was left on the floor overnight after a fall and other rest home residents were left soaked in urine.
Those claims are part of a raft of complaints made this year about a number of aged care facilities, details of which have been obtained by the Herald on Sunday.
Documents outline disturbing allegations, including elder abuse, residents being left with painful bed sores, and staff not responding to stroke symptoms and refusing a family member's request for help taking their relative to the toilet.
Some complaints led to action, including a back-down over incorrect and costly charges for a so-called "premium" room. However, others weren't substantiated by district health boards, and in at least one case that appears to have happened based largely on the facility's own inquiries.
There are now renewed calls for the Government to beef-up efforts to protect residents and their families, including through the establishment of an aged care commissioner, which Labour and the Green Party campaigned on, but have so far failed to take action on.
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One of the most serious complaints was made in February by Age Concern about O'Conor Home in Westport, home to about 60 residents including those with advanced dementia.
Age Concern was contacted by a member of the public who, documents indicate, worked at or was associated with the rest home. A "very sick elderly gentleman who has trouble with mobility" was in bed when a caregiver checked on him, Age Concern explained in a summary email forwarded to the DHB.
When the man lifted his hand to a support ring the caregiver thought he was going to hit her, so she pinned him down. "But as the other carers know you just stand back until he has moved, not pin him down," Age Concern wrote.
"[Redacted] witnessed her putting her hands around his throat and swearing at him... [she] is well known to swear at the residents most of the time and is very rough with them", the complaint contended. Multiple incident reports were filled out "plus many statements from other caregivers about [her] attitude towards the residents".
Our rest home shame: Death, hunger and expired meds
An earlier complaint had been made after the caregiver was allegedly overheard threatening to slap somebody for not doing what they were told: "once again complaint made but nothing was done".
After the complaint, West Coast DHB contacted the home. "There are a few staff interpersonal dynamics alive, but in fact the staff member in question has acted inappropriately," a file note from the DHB summarised.
The local Chamber of Commerce had advised the rest home that a dismissal would be "treading on thin ground" and a written warning was given. The caregiver was taken off night shift and ordered to retrain.
"Since this complaint other staff have come forward with historical information, so staff have been reminded that they need to discuss concerns with management before the end of the shift," the DHB noted.
A person who answered the phone at O'Conor Home declined to comment. Emailed questions went unanswered.
Philip Wheble, general manager of the West Coast DHB, said it had confidence in O'Conor's management team as well as the Ministry of Health's auditing process.
"The manager of O'Conor Home informed us that the allegations were unsubstantiated and that they followed their approved standard procedures for following up on complaints and allegations, and that contacting the police in this case was not necessary."
Complaints about other rest homes included staff at Canterbury's Bloomfield Court who decided to leave a resident on the floor from about 2am until 7am, after she fell. The DHB investigated and agreed the response was inappropriate, despite the woman being made comfortable and not suffering ill-effects. New policy has since been developed.
Associate Health Minister Jenny Salesa received preliminary advice from officials on setting up an aged care commissioner over a year ago. She told the Herald on Sunday it was still under consideration, and a number of changes were being made to better protect rest home residents.
Mandatory standards were being reviewed, an "opportunity to make changes to better reflect contemporary practices including in the areas of staffing, consumer rights and complaints".
"We are also looking into other quality improvement initiatives, which include improved complaints management processes through DHBs and the Ministry of Health so that issues can be resolved more rapidly and satisfactorily."
Grey Power national president Mac Welch said a powerful watchdog was urgently needed.
"We are totally distressed and very upset with [Labour] that they haven't kept their promise. It was a firm commitment given by the current Minister of Health prior to the election. Now they're elected, they don't want to know about it."
Simon Wallace, chief executive of the NZ Aged Care Association, said poor care was never condoned, but when instances did happen a very robust complaints process was in place - first to the facility itself, then if necessary to the DHB or Ministry of Health, and finally to the Health and Disability Commissioner (HDC).
The association represents providers accounting for more than 90 per cent of the sector and about 36,000 beds and was working with the ministry to raise awareness of the process, which it sees as a way to improve services, Wallace said. There were also rigorous audit and reporting requirements.
"An aged care commissioner would effectively just replace the HDC. Rather than establishing another watchdog alongside the existing one, we would prefer to see the Government take steps to hasten and streamline the current resolution process. It takes far too long."
What they campaigned on
Australia recently set up an independent Aged Care Quality and Safety Commission to crack down on widespread failures in rest home care and monitor tough new standards.
In New Zealand, both Labour and the Green Party together with Grey Power held an inquiry into the sector shortly before the last election, and produced a report calling for big changes.
Those included updating voluntary aged-care standards and making them mandatory, and setting up the Office of the Aged Care Commissioner and position of Aged Care Commissioner, to help enforce standards. Other recommendations were to set up a star rating for rest homes, and investigate whether the current process for complaints from residents and families is good enough.
A week before the 2017 election David Clark, now Health Minister, said the new Aged Care Commissioner would be provided for in a Labour-led Government's first Budget. Doing so is still under consideration, the Government says.
NZ First is apparently supportive of change - the party's MP Jenny Marcroft this year presented a 14,000-strong petition for the establishment of a commissioner for the elderly.