A man who won legal action over a rest home's care for his late mother says a district health board's response was toothless and failed other residents.
Robert Love met with a top Ministry of Health official in Wellington this week, after writing to Health Minister David Clark about how DHBs keep a watch over rest-home providers.
Love's 92-year-old mother Freda died in Waikato Hospital last year, and he later won a Disputes Tribunal case against Bupa, which operated the St Kilda rest home in Cambridge.
The tribunal found a failure to provide a reasonable level of care, and the case prompted Consumer NZ to call for an aged-care inquiry.
Love told the tribunal of 14 documented instances of care shortfalls. On one occasion he found his mother shivering in a urine-soaked bed with the window of her "premium" room open and call bell out of reach.
How the DHB responded to his concerns was much of the focus of his meeting on Monday with Emma Prestidge, the Ministry of Health's group manager of quality assurance and safety.
He has now written again to Clark asking for the DHB's actions to be reviewed, and suggesting a wider inquiry into aged care.
Love obtained under the Official Information Act a letter from Fiona Murdoch, Waikato DHB's manager for the health of older people, to Bupa St Kilda's facility manager, written the month after his mother's death.
In the letter, Murdoch noted Bupa had acknowledged several instances of "less than satisfactory" care.
"We appreciate that Mr Love's expectations around his mother's care were difficult to meet and there appears to be a common theme of failed communications between different staff, senior staff, and Mr Love," Murdoch wrote.
Some areas for improvement would be highlighted to the audit team before the next scheduled audit of St Kilda, Bupa was advised.
"Thank you for your co-operation and provision of requested documentation. We acknowledge this was a difficult situation for all concerned," the DHB signed-off.
Love said that letter would have been the end of the matter, had he not gone to the disputes tribunal. It was deeply insulting and showed a clear bias towards Bupa by the DHB, he said. No immediate spot audit or inspection of St Kilda rest home was ordered by the DHB.
"Waikato DHB adopted Bupa's language … [the letter] evidences an almost collaborative approach between the DHB and Bupa."
Murdoch said the DHB was sorry to hear Love took offence to the letter to Bupa, "but we believe this was an appropriate response".
"It expressed our disappointment in their actions in several areas and addressed the need to ensure that the corrective actions were underway."
Love's concerns about his mother's care were fully investigated, and HealthCert had since audited the rest home.
"All appropriate follow-up action was taken … we take any complaints about the providers we fund seriously and we are sorry that Mr Love had such a distressing experience."
Following the disputes tribunal decision Bupa said it regretted the distress endured by Freda Love, apologised to the family, and worked to put in place better practices and policies, including management of continence care.
Jan Adams, managing director of Bupa NZ, said it was important to stress the company had no influence over a DHB review.
"We comply with any request for input to a complaint investigation but in no way seek to influence their process or decisions beyond the provision of information. That approach and independence occurs whether it is a DHB, HDC [Health and Disability Commissioner] or any other agency, as it should."
Simon Wallace, chief executive of the NZ Aged Care Association, said it believed the complaints system was rigorous and effective.
"However, any complaints process can always be improved. In particular, with the current HDC [Health and Disability Commissioner] system, which has been in place for 20 years, there is certainly scope to improve the timeliness of the procedure."
The Health Minister's office said he didn't wish to comment, including on whether changes could be needed in the way rest homes are regulated.
A Weekend Herald investigation into the rest-home sector has found a third of the country's 651 facilities have had recent and significant shortcomings related to resident care, including care plans not being updated or detailed enough to guide staff.
Going into last year's election Labour's policy included establishing an Aged Care Commissioner and an improved process for people to complain about rest homes. The Herald has unsuccessfully sought an interview with Clark on rest homes for two weeks.