For about two months, New Zealand's largest service provider for intellectually disabled adults has banned baths at its residences.
The news came in a notice from IHC chief executive Ralph Jones in September. It also stated the use of spa pools or pools in residential homes and facilities had been banned.
According to Jones, the ban was due to a court decision over the death of a 63-year-old woman who drowned while unsupervised in a bath at a support home in Waitara, Taranaki in 2016. The July sentencing decision fined IHC's service delivery arm - IDEA Services - $425,000 for failing health and safety duties and exposing the woman to risk of death and serious injury.
That outcome meant the organisation's "duty to minimise the risk of baths was greater than people's right to choose to have one", Jones said.
"Bathing is considered a high-risk activity and we're required to take reasonable steps to eliminate or minimise this risk."
Effectively, if you stay or live at an IHC residence, the perceived health and safety risks around taking a bath were now too much for the organisation and its staff to handle - even if this was a regular part of your day and something you enjoyed and wanted to do.
Tragic background to decision
It's a stance which has raised a number of issues. Yes, IHC has ongoing problems around underfunding and poor resourcing - reflective of the wider neglect of services for intellectually disabled adults. That in turn has been linked to its inability to "deliver safe bathing".
However, is an outright ban on baths - which add value to the daily lives of many who stay at IHC residences - really the best course of action? Further, for an organisation set up to advocate and uphold the rights of those with intellectual disabilities, what does a policy like this really mean? Are things so constrained, it's now impossible to enable individuals the basic choice between a bath or shower?
Here, a bit of background into the decision is important. Sadly, there have been two drownings in baths at IHC residences. In 2015, 15-year-old Nathan Booker died at an IHC home in Palmerston North after being left alone in a bath. IDEA Services pleaded guilty to health and safety charges over his death. Circumstances of both Nathan's death, and the 63-year-old woman in Taranaki, need to be examined alongside the current decision to ban baths.
First, it was established through several investigations Nathan had been left alone in the bath by staff when he shouldn't have been. On the evening he died, two care support workers were in charge of six high-needs residents at the home he was staying in for the weekend. Nathan was left unsupervised when one of the care support workers left the bathroom to assist the second worker with another resident.
Serious faults were found in the worker's actions and IDEA Services' health and safety systems, prompting the judge in the case to say Nathan's death was "avoidable".
'It was the one thing he looked forward to'
Also important is insight from Nathan's mother Angela Middlemiss. Middlemiss cared for her son five days a week. Having access to a bath did not lead to his death, she said.
"He loved them so much. It was the one thing he looked forward to each day," she told RNZ.
The death of the 63-year-old woman, whose details have been permanently suppressed, occurred two years after Nathan died. Similar to Nathan, she was left unsupervised when she shouldn't have been. The care worker at the time said she left the woman alone to complete paperwork in the nearby office.
IDEA Services was found to have failed several health and safety duties, including not having a care plan for the woman and failing to assess the level of support she needed to use a bath. It meant staff members who cared for the woman also did not have this information.
Together, both deaths show what happens when critical health and safety protocols are absent. However, as Nathan's mother and other intellectual disability advocates have pointed out, an outright ban on baths isn't the answer.
Rather, IHC should look at why its current systems and staff are failing to ensure key safety measures, and make changes from there. Because, as it stands, the organisation's current setup simply robs those it's supporting of basic choices that enable more independent and dignified lives.