Consumer expectations of aged care 09 March 2015

What consumers want Quality care Quality information on which to make decisions about care

The problems Consumer NZ’s recent review of surveillance audits for 123 rest homes found less than 14 fully met all the health-care criteria they were assessed against 54 had 1-3 shortfalls 26 had 4-6 shortfalls 16 had more than 10 shortfalls

The problems Some shortfalls were minor but many instances of disturbing failures in basic care Majority of homes had 1 or more shortfall auditors described as “moderate risk” to residents 39% of shortfalls were classified “moderate” or “high risk” Audits showed several homes had recurring problems

The problems Safety Standards The voluntary standard “Indicators for safe aged-care and dementia-care for consumers” should become compulsory to ensure the protection of both carers and older people The “Home and Community Support Sector” standard must also be compulsory ◦ Human rights Commission 2012 recommendation

The problems Audit processes are improving The same assurance can’t be given about the quality of care Ministry of Health agreed audits will continue to be publicly available

The problems Funding Appreciate the industry thinks there is a lack of it particularly from the govt BUT…

BUT - state of the industry Metlifecare, posts net profit of $39.7million up 48% It has 198 units, apartments and care beds under construction, wants to lift that to 200 per year Rival Ryman Healthcare in November announced underlying profit up 13% to $66 million - a new record Summerset Group Holdings increases net profit 58% to $54.2 million and is in “big expansion” phase An ageing population means retirement village stocks are among the 15 best performing companies on the stock exchange The state subsidises the industry by more than $1 billion a year to look after the elderly

Care workers Mrs Kristine Bartlett has worked in aged care for more than 20 years and is paid just $14.46 an hour. Has won appeal against her employer Terranova – she should be paid the same as similarly skilled men in different industries In the case of Malvina Major, nurses claimed there was one nurse on for 200 residents and patients

If you believed it…. Too few staff Residents not receiving adequate care Poor cleaning Poor nutrition – dinners consisting of tinned baked beans or spaghetti, dementia residents losing more than 10kg in 7 months That’s a brief list of some of the disturbing problems uncovered by unannounced inspections in the past three years

How serious are the shortfalls? Deficiencies in rest home monitoring have made it difficult to find out – but improving Our review of the summary audit reports for the rest homes remains one of the few publicly accessible sources of information on rest home care – the raw data presented by MoH is difficult to follow for families looking for rest home information

The solutions Openness forces accountability The Dominion Post suggests complete and detailed reports similar to ERO reports – rest homes after all are looking after some of our most vulnerable people as do schools We have suggested changes to the MOH which had not been taken up

What information CNZ wants Routine audit reports While full reports are now made available, they are not easily searchable. No summary of rest homes in your area Access to information about the healthcare criteria/standards that each home has not met, the corrective actions required and the date actions must be completed – this is better than it was Progress updates to show whether corrective actions have been achieved by the required dates – not all homes have been done but this information is being progressively updated

Information for consumers 2. Information about substantiated complaints Is not routinely published from the ministry or the District Health Boards. We would like to publish it. Now we have to request it under the Official Information Act which is time consuming

Information for consumers 3. Rating system Human Rights Commissioner Judy McGregor recommended a five-star system of quality assurance comparing residential facilities, with the aim of improving consumer choice and public accountability Consumer NZ has a history of providing rating systems and has a particular interest in aged care. It would like to build such a rating system

Information for consumers 4. Retirement village information Key information consumers need about retirement villages is about costs and contract terms. This information is often not easily accessible as it’s buried in contracts or has to be requested from the village. We would like to collect costs and contract information from each village

Information for consumers 5. One responsible body Currently DHBs aren’t routinely publishing results of complaints and inspections; There’s a big gap between the health and disability commissioner investigating and reaching a decision; and the Ministry of Health only recently began publishing unannounced inspection reports What’s needed is one body independent and responsible for overseeing the sector and providing information for consumers – an ombudsman

The (nearly) last word From Judy McGregor – Human Rights Commissioner “The value we place on older people is linked to the value we place on those who care for them.”

Thank you