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

Health and Disability Commissioner
Breach — Aranui Home and Hospital Ltd t/a Oak Park Dementia
Unit
230. Ms A was admitted to Oak Park on 23 August 2007, and remained there until 20
October 2008. She made it clear on many occasions that she did not wish to be there.
Oak Park initially had information that led it to believe she was required to stay there
and was not competent to make decisions about her care. However, it failed to verify
Ms A’s legal status, or to ascertain who could make decisions on her behalf and who
it should be consulting and communicating with in relation to her care. Once it
became apparent that Ms A’s competence was improving, it failed to take sufficient
steps to have her situation reassessed and arrange for the removal of the order that it
thought was in place.
231. Once again, I find it deeply disturbing that a facility of this nature should clearly fail
to be aware of the legal process for the secure care of residents such as Ms A. In my
view, Oak Park breached Right 4(1) of the Code. 41
Legal status
232. Staff at Oak Park had limited information about Ms A at the time of her admission
but, like Taikura Trust, they had ―reasonable grounds‖ for considering she was not
competent to make informed decisions and give informed consent. This was indicated
in the discharge summary that staff received on the day of her admission, and in Dr
C’s report obtained subsequently. Staff do not recall exactly what they had been told
verbally about Ms A’s legal status at the time of her admission, and there is nothing
documented about this. It appears they believed there was a legal requirement for Ms
A to be accommodated at Oak Park, but they thought that this matter had been
addressed by ADHB and/or Taikura Trust and nothing further was required of them.
233. This is not acceptable. Oak Park too, had a responsibility to verify Ms A’s legal
status, and to be clear about the legal basis on which it was to provide services. While
this is important for all health and disability service providers, the fact that Oak Park
is a secure facility with the ability to physically detain people, and it routinely
provides services to people with diminished capacity, means it should have been
particularly vigilant. I note also that if, at the time of Ms A’s admission, Oak Park
provided services on the understanding that she was unable to give informed consent
herself, insufficient consideration was again given to the implications of this. Surely,
any provider in this situation would immediately ask: who can consent on this
person’s behalf and who should we therefore be communicating and consulting with?
In other words, aside from its failure to verify Ms A’s legal status, it failed to even
begin to take the necessary action that would follow from an understanding that she
was not competent to give informed consent. If, as they assumed, a personal order had
been made, Oak Park staff should have obtained the order and determined from it
whether it appointed a welfare guardian and/or provided that particular services were
to be supplied to Ms A.
41 See footnote 2.
40 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.