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

Health and Disability Commissioner
her discharge from Oak Park cannot be used to justify her inappropriate detention.
The point is that in most circumstances, people retain the right to make their own
decisions — irrespective of whether these decisions are in their best interests. Most
people, most of the time, have the right to make bad decisions. There are situations in
which denying people this right is justifiable, and that may well have been the case
with Ms A because of her diminished capacity. However, doing so is a serious matter
that challenges fundamental human rights. In such circumstances, it is critical that due
care and attention is paid to ensure the protection of the person’s rights and freedoms.
Care provided
242. Oak Park supervisor Ms M recalls staff from ACH visiting Oak Park a few days
before Ms A’s admission. This is unlikely: it is not usual practice, there is no evidence
of such a visit in the records of Oak Park or ACH, and in fact Oak Park is not
mentioned in ACH’s records until the day of Ms A’s discharge.
243. On 23 August 2007, Ms M was informed by phone that Ms A would be arriving by
ambulance that day. Communication between staff at ACH, Taikura Trust, and Oak
Park prior to, and on the day of admission is not well documented but appears to be
limited. Ms A arrived with a discharge summary and transfer form. There was some
discussion between Ms M and RN N in relation to Ms A’s admission, but RN N
recalls that it was not until she met Ms A later that day, that she became aware of her
age.
244. The decision to accept a new resident should be made on the basis that the facility
anticipates being able to provide care appropriate to that person’s needs. I am
concerned about the information — or lack of it — on which Oak Park staff based the
decision to accept Ms A. While it is fortunate that there are residential facilities
willing to admit people with impairments that other facilities may deem too difficult
or challenging, careful consideration should still be given to the individual
circumstances and needs of potential residents. Not doing so jeopardises the safety
and well-being of the potential resident, current residents, and staff.
245. Oak Park submits that it was Taikura Trust’s responsibility to ensure Ms A’s
placement met the access criteria set out in the placement agreement. It states that it
acted on the instructions of Taikura Trust, and suggests that it had little or no say in
the decision to admit Ms A. I disagree. Oak Park not only had a say, it had a
responsibility to consider whether it would be able to provide an appropriate service
and, indeed, meet the requirements set out in the placement agreement with regard to
her ongoing care. In HDC’s experience, it is not uncommon for facilities to decline
admission if they they do not anticipate being able to meet a person’s assessed needs,
or to seek a person’s transfer if they subsequently find that they cannot do so.
246. Additional information was later obtained from Taikura Trust following the NASC
assessment on 29 August, and from ACH following RN N’s request on 21 September.
247. Staff at Oak Park consider that they did their best to provide an appropriate service to
Ms A while she was resident there. While I accept that there were some improvements
42 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.