Report on Inspection of Aged Care Facilities In Alert Levels 3 and 4

peter boshier

The Chief Ombudsman has said that his independent inspections of privately run aged care facilities offer some valuable lessons for the sector.

Peter Boshier’s released report on his inspection of six facilities providing secure dementia and psychogeriatric care, during COVID-19 Alert Levels 3 and 4 in April and May 2020 shows that the facilities inspected were strongly committed to residents welfare but some practices needed improvement.

Boshier said that all facilities had policies and plans for infection control, good hygiene practices, and general policies preventing visitors from entering. Most facilities put these into practice and worked to minimise physical contact between staff and residents.

None of the facilities he looked at had any confirmed or suspected cases of COVID-19 at the time of inspection.

Aged care facilities, like the rest of New Zealand, used the ‘bubble’ strategy to prevent the potential spread of infection. The facilities aimed to operate bubbles, separating groups of residents from each other. Movement between units was minimised and they avoided outside contact in most instances.

The report, however, said that the makeup of bubbles created confusion in some facilities about who should be included or excluded. This appeared to lead to some inconsistent use of PPE by people entering some sites, potentially risking the health and safety of the residents and staff.

PPE practices varied across facilities, with the staff of one facility wearing masks and gloves at all times when around residents, while staff in other facilities wore PPE only when they were helping residents with personal tasks like dressing.

Plans and processes were in place for isolating residents with suspected or confirmed cases of COVID-19 from other residents.

Boshier said he is pleased that all the facilities focused on keeping residents in touch with their families. While many whānau weren’t able to visit their loved ones face-to-face due to visiting restrictions, they were able to communicate by other means including phone or video calls.

"Some facilities did exercise discretion in allowing some family members to visit dying relatives in palliative care. I was concerned to find that one facility’s default position was a blanket refusal,” said Boshier.

"All but the most independent of residents require assistance to make a complaint. I am concerned their ability to raise issues or concerns in private was reduced while the ‘no visitors’ policy was in place."

Boshier said the Ombudsman has the role under a United Nations human rights convention to inspect certain designated places where people are unable to leave at will. This includes privately run aged-care facilities. The Ombudsman’s inspection role was designated an essential service during the initial lockdown period in March-April.

"Residents in secure care are some of the most vulnerable in society. There is a need for an independent assessment of their treatment and conditions during lockdown when the extraordinary use of state power results in significantly reduced oversight and access,” he said.

The Chief Ombudsman made four recommendations across two facilities to improve practices and 21 suggestions for improvement across all six of the facilities inspected.