One man's drive to shake up rest home care

Geoff Harper. Photo / Alan Gibson

Fired up by the death of his elderly mother, Geoff Harper has gone on a one-man campaign to force improvements in rest home care.

The 65-year-old retired auditor from Tauranga has analysed the sector and concludes its woes include short-staffing, "sham" audits and weak regulation.

Today, he reveals his findings in his Report on the Dysfunctional Provision of Rest Home Care and Funding in New Zealand.

Mr Harper began his campaign after the death of his 100-year-old mother, Anne, last year. He glimpsed the sector's difficulties as he tried to investigate her care in a rest home where care is subsidised by the Bay of Plenty District Health Board.

He said: "We wanted to be present with the [DHB-appointed] auditor to make our complaints. We weren't allowed. The audit gave everything a clean bill of health. All the systems were 'fine'. That was after my mother contracted scabies, went into hospital, got infections and died."

Mr Harper's report found the regulatory system established in 2001 to govern rest homes was difficult to enforce.

Its vague language gave home owners - now mostly profit-making organisations - licence to decide things such as how many showers a week were "adequate".

"Emphasis was on providers having no additional compliance costs, to the significant disadvantage of not making the standards measurable, auditable, leaving them open to misinterpretation ..."

Mr Harper insists, supported by the Nurses Organisation, that staffing levels need to increase. The Health Ministry's recommended minimum rest home staffing level, set in 2005, is 12 hours a week per resident.

But DHBs, in their agreement to provide subsidies, set a level of nearly 17 hours a week for smaller homes.

A survey of providers last year found they fell short of both levels. The range was 10.6 to 11.5 hours a week per resident. A Nurses Organisation survey in 2005 found actual caregiver hours were 56 per cent of the ministry's recommended minimum.

On auditing, Mr Harper said the weaknesses were summed up by the statement on one audit agency's website that, "It is important to recognise an audit is not an inspection. The auditor is not trying to 'catch out' personnel."

He sent his report to Health Minister Tony Ryall, who replied at length. He defended the 2001 regulations, which he said moved from stipulating inputs to guiding providers in offering services "safely and at a reasonable cost".

On staffing, the minister said rest homes were required to provide "sufficient staff, of appropriate skill mix".

He said Mr Harper's report failed to consider the improvements in auditing instituted by the Government since the Auditor-General's 2009 investigation into rest home monitoring.

THE NUMBERS

* 12 hours a week - Health Ministry's recommended minimum rest home caregiver staffing level

* 17 hours a week - DHBs level for smaller homes

* 10.6 to 11.5 hours a week - levels achieved by providers in survey last year