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Latest neglect case another victim of bureaucratic buck-passing

The State Government’s response to another disturbing case of neglect in disability care raises questions about its ability to recognise and fix the issue, writes Jemma Chapman.

Feb 16, 2022, updated Feb 17, 2022
Health Minister Stephen Wade. Photo: Tony Lewis/InDaily

Health Minister Stephen Wade. Photo: Tony Lewis/InDaily

Sickening details emerged this week about the neglect of a vulnerable man in a government-run disability care facility.

Incontinent and requiring a wheelchair, he was found unresponsive in foul and dangerous conditions.

The patient, now known as Mr D, was wearing soiled underwear and dirty clothing. He appeared unwashed and malnourished and had infected pressure wounds on his neck and face, leaking pus.

The paramedics called to help him were so alarmed about his condition, they lodged a formal complaint – as did staff at the Royal Adelaide Hospital.

Thank goodness they did.

Those complaints led to a lengthy and thorough investigation of the case, first revealed by InDaily last year.

The independent health watchdog handed down his findings this week. The public summary detailed a litany of failures, making several recommendations for change and prompting a series of apologies from government officials including the Premier.

The 35-page report by the Health and Community Services Complaints Commissioner, Associate Professor Grant Davies, painted a grim picture.

Many reading it would have been reminded of the horrific case of Ann Marie Smith, a vulnerable NDIS client with a carer, who died in hospital in 2020 of septic shock and organ failure after being found at home in filthy conditions and with infected pressure wounds.

Not the Health Minister.

“This is a world of difference from Ann Marie Smith,” Stephen Wade told reporters on Monday afternoon.

“We’ve got a situation where Ann Marie Smith’s former carer is before the courts for criminal neglect – months and months of neglect of a client. Completely different in relation to Mr D.”

Yes, fortunately this man did not die as a result of his neglect.

Wade insisted: “This gentleman was receiving daily personal care, he was receiving daily baths, he was receiving pads for his incontinence. The situation was not in relation to his personal care.”

Not in relation to his personal care? Did the minister read the report? Was he briefed incorrectly by his department?

The SA Ambulance Service’s official complaint, contained in the Commissioner’s report, states:

“SAAS staff found patient with dirty clothing (had not been changed for a few days). Malodourous body odour and poor personal hygiene due to the negligence of carers.”

“Patient’s case worker and sister report patient has been found in this state (left in faeces and urine (for) prolonged periods of time, with a dirty moist towel over infected wound site),” the complaint says.

“SAAS staff also found the wound care of the RN (registered nurse) to be neglectful and subpar…”

The Transition to Home (T2H) service where the man was supposedly being cared for at the Hampstead Rehabilitation Centre is a step-down transitional accommodation facility for people with disabilities who have been discharged from hospital, until long-term housing can be found.

It is a partnership between the Department of Human Services (DHS) and SA Health, but is run by DHS.

As such, the minister actually responsible is Human Services Minister Michelle Lensink – who went to ground this week, declining several requests for interviews.

Instead, she left it to her media adviser to issue a statement conceding “T2H failed the client and did not meet the required benchmarks for support and care”.

“As recommended by the Commissioner, DHS has immediately actioned new processes and systems to ensure the quality of care at the T2H service meets required standards,” her spokesperson said.

Lensink should show leadership, explain what happened and apologise for the lack of dignity and care of a patient under her department’s watch.

But Wade has some responsibility too – it is a partnership project and one of his regional hospitals discharged Mr D into the care of the T2H facility, without ensuring appropriate services were arranged with his NDIS care coordinator to meet even his most basic needs.

At least Wade stood up to answer media questions about this latest disturbing failure in disability care.

But he should not have glossed over the facts clearly laid out in distressing detail in the Commissioner’s report.

Refusing to address that Mr D was found sitting in his own filth, Wade would only focus on his “medical” needs.

“This unit failed to, if you like, identify his medical needs. It’s not a medical facility,” he said.

“What the Commissioner’s report has highlighted is the Department of Human Services needs to make sure they’ve got line of sight of the medical needs of their clients, not just the personal care of these clients.

“The Department of Human Services completely acknowledges that and is in the process of fixing it.”

Even when reporters read extracts of the Commissioner’s report to Wade, detailing Mr D’s soiled clothes and paramedics’ concerns that he was left to sit in faeces and urine, the minister was unmoved.

“My understanding is that the client did receive daily baths and was receiving pads,” he said.

It was only when asked if he would apologise to the man and his family, that he did.

“We always apologise to our clients where we let them down, where we fail to deliver the quality of care that they need but the best way to show respect to people when we do let them down is to make sure we take every step possible to make sure it doesn’t happen again and that’s exactly what we’re doing,” he said.

Another way of showing respect would be acknowledging the errors that led to a vulnerable man being left to sit in his own waste in a government-run facility.

InDaily asked the Commissioner if he had any thoughts on Wade’s assessment and understanding of his investigation report.

“It’s my view it is inappropriate and there is nothing to be gained by entering into public debate about investigation reports,” Davies responded.

“My findings are set out in the public summary I released Monday. My hope remains the same: that the learnings from this report can avoid something like this happening again.”

Don’t we all.

The Minister was right about one thing – there are clear differences from the Ann Marie Smith case.

This wasn’t a private individual responsible for the neglect of a vulnerable South Australian with disabilities, but government bureaucracy.

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