Dear Hon Dr Clark Both the Waikato DHB and Bupa have recently issued statements that misrepresent the situation at the St Kilda Rest Home in Cambridge.

An unannounced audit in June found many serious failures and problems at the St Kilda Care Home to be on-going from 2016/17. It should be alarming that it took the DHB this long to call for the audit. Why did the mistreatment and abuse that took place in Bupa St Kilda during 2016 and 2017 not triggered unannounced audits over 18 months ago?

There can be no doubt that had I not persisted with my concerns the June audit would not have been undertaken. The reluctance on the part of the DHB is in itself very concerning. The audit in June found many issues to be seriously wrong at Bupa St Kilda while highlighting the inadequacy of scheduled certification audits which are announced, expected and prepared for, by the Care Home owners. All audits, to be meaningful, should be unannounced. Following the reporting of this audit the DHB response and treatment with Bupa should also give rise for concern.

Following the audit, the DHB met with Bupa management from both the facility and Bupa Head Office on the 13th of July. The outcome from that meeting allowed the least amount of further independent inspection or review of Bupa possible and a statement from the DHB that contradicts the findings of the audit. How is this possible or justified?

Seven days after their meeting with Bupa the DHB wrote to Consumer NZ and myself. This letter states that the audit did not find that the residents were at risk or that care was unsafe. It further states that the issues complained about in 2017 were not on-going. To briefly restate the audit found:
• Staff failed to respond to call bells within the home’s expected three-minute time frame, with some call bells left unanswered for more than 20 minutes.
• Care planning standards varied among nursing staff. There were two instances where no plans were in place to treat residents’ medical needs. Four out of 12 long-term care plans had not been evaluated within the expected six-month time frame.
• Corrective action plans weren’t in place to address improvements required following complaints and there was a lack of evidence to show residents’ family members were involved in care planning. • Additional staff training was also required. The inspection report stated the registered nurse designated as the “wound nurse champion” had not received adequate training.

The contortions necessary for the DHB to support their statement requires a ridiculously narrow view of past failures at this facility and the complaints that had recorded them. The following example illustrates this point well. In 2016 and 2017 there had been frequent complaints of excessively long delays responding to call bell requests for assistance.

One verified occasion involved multiple requests while waiting almost 3 hours for assistance to go to the toilet. As can be clearly seen long delays to calls for assistance continue at St Kilda. The targeted response time is 3 minutes.

While the audit did not provide worse case examples it did provide evidence of many incidents (>20 minutes) over multiple months.

However, because the audit did not find an example equal to 3 hours the DHB conclude that the historic problem of excessively long delays was not found. How leaving a vulnerable elderly person waiting unattended for more than 20 minutes can be described as safe or does not place them at risk is also a moot point. It appears that something similar to this illogical extrapolation was applied in every instance where it might reasonably be claimed that the problems I described in 2017 at Bupa St Kilda were found to be on-going.

In other words, it looked at the worst case in 2016/17 and when it did not find something that equalled or exceeded that it was satisfied that the issue was not on-going. This selective view by the DHB is simply unacceptable. Further, regardless of whether a direct line can be drawn between what was going on in this facility in 2016/17 and June this year, this recent audit is alarming and deserves more than this casual hands-off response from the DHB. Following the audit report Waikato DHB had a small sample of five (5) residents records reviewed.

There are concerns that I have with the methodology used in this review but allowing this to stand it remains a limited review of records conducted weeks after the audit. It is this very limited review of documents that Bupa misleadingly refer to as a “follow- up audit” and misrepresents in order to diminish the findings of the audit's evidence.

On Friday last week the Chief Operating Officer for Bupa issued a written statement which was widely reported. This statement is incorrect and objectively misleading. In the Bupa statement it is twice asserted "a follow-up audit by an independent reviewer at the end of June found there was no evidence of the historical complaints of poor care that had been provided to the auditor". This is misleading because it was not an equivalent audit but a review of a very small number of residents records – five to be precise. Furthermore, contrary to Bupa's statement the June audit did not find competency in wound care, it found that the one Registered Nurse was designated wound champion and "had not received adequate external training to support the overall responsibility of this delegated duty".

Nor did the Audit find, as Bupa claimed, that 9 out of 10 staff were adequately trained in dementia care. The Audit found that in the past two years the opposite was true; 9 out of 10 had received no training on Managing and Care for the Dementia Client.

The June audit also found, contrary to Bupa's media release, that care plans were not consistently individualised and appropriate for each resident. Indeed, it found that a third had not been reviewed within the mandatory period, some were four months beyond the mandatory period of six months. I note that the DHB have been noticeably silent in correcting Bupa's misrepresentation. Why does this distortion of the evidence matter?

The truth does matter. It is entirely possible that someone, whether for themselves or a loved elderly family member, may rely on the reassurance derived from these representations. They would be wrong to do so because it is misleading and false.

It is in the nature of organisations (both State and Commercial) to defend themselves but this should not allow them to mislead the public. Beyond the puffery of their glossy marketing material Bupa have an established history of false claims and misrepresentation.

This is yet another example. We must hold Waikato DHB to a higher standard. Waikato DHB know Bupa's statements to be inaccurate and they have a duty to call this out and demand Bupa redress and correct this behaviour. With respect I fear without Ministerial interest and involvement this is unlikely to happen. That Sir, is to the reason I write again to you calling for your review. All in New Zealand deserve a better measure at the end of their journey than is presently being supported.
Yours sincerely
Robert M. Love.

© Scoop Media