Auckland District Health Board Taikura Trust Aranui Home and ...

Health and Disability Commissioner
admission to ACH in the context of a hospital that often runs at 95–99% capacity,
particularly in winter. He submits that this pressure on beds impacts on the
management and safety of patients such as Ms A.
127. Dr R comments on the resistance commonly encountered in obtaining long-term care
for patients such as Ms A. He describes how ―extraordinary delays‖ become ordinary,
contributing to a ―learned helplessness‖.
128. These issues, Dr R states, relate to organisational motivation, structure and resourcing.
He also notes his concern that greater fidelity to the checks and balances related to
PPPR Act applications will prevent errors, but may also introduce delays and an
excessively conservative approach to PPPR Act applications.
Taikura Trust
129. Taikura Trust did not respond to my provisional findings, but subsequently responded
to the recommendations outlined in my provisional report.
130. Chief Executive Ms G apologised to Ms A’s family for Taikura Trust’s failure to
provide Ms A with the service it promises its clients, and for breaching Ms A’s rights
under the Code. Ms G offered to meet with Ms A’s family if they wished to do so.
131. Ms G advised that:
Two practice advisors are developing a training programme and guide in
relation to the PPPR Act and the HDC Code of Rights, to be delivered to staff
through a series of workshops in October and November 2010.
Taikura Trust has been drawing on recent experience with other clients subject
to personal orders under the PPPR Act. Its goal is to lift the overall knowledge
and capability of its employees generally, and to establish experts in the Act
and its requirements who can act as mentors to their colleagues and establish
networks with other relevant organisations.
Taikura Trust has been working to improve the interface with mental health
services across Auckland, so that clients with dual needs receive a more
consistent service and access to appropriate supports. It began engaging with
mental health teams from the three local district health boards over 18 months
ago, in an effort to improve information sharing, establish key contacts and
agree pathways. A pathway document was signed with ADHB’s mental health
service in June 2010.
In September 2010, a hospital ―in reach‖ position was established. The role
was designed in conjunction with ADHB, and involves a staff member based
at ACH to undertake eligibility screening, needs assessment and initial service
co-ordination. This is currently being tested in the medical and rehabilitation
wards, with the intention of extending it to the mental health service, Starship
Hospital, and across the other two local DHBs.
A Practice Development Leader was employed in February 2010, to help
address gaps in areas of clinical competence. Under her leadership, a team of
22 3 November 2010
Names have been removed (except Auckland DHB, Taikura Trust, Aranui Home and Hospital/Oak
Park Dementia Unit and the expert who advised on this case) to protect privacy. Identifying letters are
assigned in alphabetical order and bear no relationship to the person’s actual name.