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Processes For Checking On Vulnerable Clients At Home

Deputy Health and Disability Commissioner Rose Wall today released a report finding community healthcare provider Access Community Health (Access) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to have adequate procedures in place when checking on its clients.

In this case, the client was a frail elderly woman who had multiple health problems and was classified as a high falls risk. She lived on her own and required twice-daily cares and safety checks to ensure that she was safe in her own home. One morning, a support worker went to the woman’s house to provide her with her morning cares and do a safety check, to find that she was not answering the door. The support worker notified Access’ Call Centre, and the "Client not Home" process was followed. The Call Centre attempted to call the woman’s house and next of kin, but there was no answer. A call was made to the local hospital, but it advised that the woman was not a patient. The support worker was advised to move on.

This process occurred two more times - later that afternoon, and the following morning - when a support worker finally gained access to the woman’s home using a neighbour’s key. The woman was found in bed, having suffering a significant cardiac event and a stroke. Sadly she passed away shortly afterwards.

Ms Wall was critical that Access’ "Client not Home" policy lacked an escalation mechanism, that there was no differentiated process for clients with different risk profiles, and that it did not align with sector standards. Ms Wall considered that by failing to have an adequate process for when a client was not at home or not answering the door, Access failed to ensure that the woman was safe, and denied her the opportunity for earlier medical intervention. As such, Ms Wall found Access in breach of the Code.

Ms Wall made a number of recommendations, including that Access provide training to all Call Centre and support work staff on its new "Client not Home" process, develop an alert system for those who require safety checks, and update its template to ensure that important information for emergencies, such as the location of spare keys, is recorded. Ms Wall also recommended that Access apologise in writing to the woman’s family for its breach of the Code, which it has since done.

The full report for case 19HDC01227 is available on the HDC website.

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