Consumer NZ says existing complaints processes for the aged care sector are inadequate and has opened a new fund to help consumers take complaints against rest homes to the Disputes Tribunal. People can apply to the fund for financial support to meet the costs of filing a claim in the tribunal.
However, the aged care sector believes the existing complaints processes are robust if people have concerns over quality of care delivered. The Health and Disability Commissioner currently takes an average of four months to close complaints – is this too long for residents and their family to wait for a resolution? Does the government need to work with agencies and providers to review how complaints about the aged care sector are handled?
The Consumer NZ fund was made possible by Robert Love, who recently won a tribunal case against rest home provider Bupa Care Services.
The tribunal found Bupa failed to provide required services to Love’s mother and misled him about its capacity to deliver those services. Bupa was ordered to pay Love $10,000, which he donated to Consumer NZ to establish a fund to help others. The new fund is called the Freda Love Fund, in memory of his mother.
Love says he wants the fund to show people in similar situations there is something you can do that has a meaningful outcome.
“The Disputes Tribunal provided a forum where I could present evidence of the failings in care provided to my mother and feel like I was being heard. That’s not what I felt when I tried to raise my concerns through the formal complaints channels,” he says.
Consumer NZ’s Sue Chetwin says existing complaints processes need to do a better job when consumers raise concerns about rest home care. Rest homes must also face meaningful sanctions when they fail to deliver care to required standards, she says.
“Just like any other trader, rest homes are obligated under consumer law to provide services with reasonable care and skill. If they don’t, and that failure results in you being left out of pocket, then you have grounds to take the case to the tribunal,” says Chetwin.
Does Disputes Tribunal need to be involved?
Both the New Zealand Aged Care Association (NZACA) and Care Association New Zealand (CANZ) believe there is a rigorous complaints system that already operates across rest homes in New Zealand.
Victoria Brown of CANZ says given the existing systems in place, the Disputes Tribunal shouldn’t need to be involved in resolving complaints about quality of care.
“In cases where there are genuine concerns about the quality of care delivered to a resident a Disputes Tribunal is not the place that such matters should be examined. This remains properly the task of the agencies charged with this task – either through the Ministry of Health or the Commissioner,” says Brown. “A Disputes Tribunal process looks not at the quality of care but at whether or not money paid or not paid through a contractual process is fair or not.”
Brown says that in the Bupa case, the verdict reached by the Tribunal was fair, as a contractual arrangement was breached. She says the fund could be useful for helping those in such circumstances.
Wallace agrees that the fund could be useful.
“In some cases residents feel the need to take their complaints further and so this fund may be useful for those with legitimate complaints where the cost of lodging a case with the Disputes Tribunal is a barrier,” he says.
Both organisations say rest homes are already highly regulated and monitored.
“The sector is well-regulated – and we should be,” says Wallace. “One case of sub-standard care is one case too many. Nothing less than the best possible care is what residents and families should expect.”
Brown says aged care facilities are monitored very closely through an audit process that takes account of every single part of the service.
External processes involve the Ministry of Health (through HealthCERT), the local district health board (DHB), and the Health and Disability Commissioner (HDC). All of these agencies have the power to investigate facilities at a very high level. The sector is accountable to the Health & Disability Sector Standards and facilities are subject to unannounced rest home audits. Under the Code of Residents’ Rights, rest homes must provide a clear pathway for residents to voice concerns and make complaints.
Complaints system is too slow
The problem is that when a lapse in quality care delivery does occur, the existing complaints processes are too slow.
In the Bupa case, Love repeatedly raised concerns with Bupa, the District Health Board (DHB), the Health and Disability Commissioner (HDC) and the Ministry of Health. Yet he only had one reply, which was from the DHB, assuring him that they had been in contact with Bupa who had addressed their failings and there was no need to take the matter further. So he had to resort to the Disputes Tribunal to resolve his complaint.
In 2016/17 the average time taken by the HDC to close complaints about rest homes was five months. In the year to date (from 1 July to 1 December 17), the average time to close complaints about rest homes has improved to four months.
The HDC says they acknowledge that complaints about rest homes are sometimes complex.
“The episode of care being complained can span an extended period of time and involve multiple health service providers and issues. Accordingly it may be necessary to collect a considerable amount of information from a number of parties. Frequently it is not possible to obtain information from the consumer themselves and HDC is reliant on information contained in clinical notes and statements provided by third parties – this adds to the complexities of the complaints assessment process.”
The HDC says the timely and effective resolution of complaints continues to be a priority. But is four months to wait for resolution of a complaint too long when it comes to the health and wellbeing of frail older people?
Wallace says the current complaints system is arduous. He says that while he understands why the HDC’s complaints process takes so long, it isn’t satisfactory.
“There is definitely room for improvement in the time it takes to address a complaint.”
Perhaps it is time to review existing processes so that people are not driven to relying on the Disputes Tribunal for a resolution.