Health and Disability Commissioner: Residential Service Client Reports Violence and Drug Use

The Department of Health investigated the care home after a complaint was made against the carer to the Health and Disability Commissioner (HDC).

The department then cut funding to the charity that runs the service after the audit raised concerns about its service and finances.

“The trust is no longer in operation,” according to a HDC report released on Monday.

The name of the disability support service and its location, as well as the names of the carer and client, were removed from the report by Assistant Commissioner Rose Wall.

The client was called Mr A and the carer Mr B, who was employed part-time by the service between 2017 and 2020 and was previously a friend of the man who had come into his care.

Wall said she found the concerns raised by A about B’s behaviour towards her “very serious” but that it was difficult to verify what had happened because of conflicting information.

Its ability to draw factual conclusions was also hampered by “the lack of independent investigation and contemporaneous documentation of these concerns by the Disability Service”.

Ms Wall said it was not disputed that A and B had consumed alcohol together. She added that this was inappropriate, even though it happened when B was off duty.

Wall said she was unable to draw a conclusion about the alleged use of cannabis because there was virtually no evidence available, other than A’s allegation that he had been coerced into doing so.

“However, if that were true, I would also be extremely critical of it,” Wall said.

She was also unsure about a video B had shown A, in which another male customer of the service was allegedly holding a sex toy.

“I am unable to determine whether the video showed a resident eating chocolate or whether it was pornographic in nature,” Wall said.

“Regardless of the content of the video, it is generally unwise for providers to show consumers content from their personal devices, particularly when the content includes humor at the expense of another consumer.”

A’s complaint, made with the assistance of his independent psychologist, referred to various incidents in which he said B had been violent towards him.

These included punching him in the gym and throwing a piece of firewood at him.

A said B had used him as a “punching bag” at the gym and he reported this to the disability service, but the matter was not investigated.

B told the commission that A had joined him at the gym and that the men took turns holding pads while the other threw punches for boxing training, and he said it was possible that he had injured A.

The service said it investigated an incident at a gym in 2019 when B “made fun of Mr A and filmed him to show his friends”.

“I consider it more than likely that Mr. B acted inappropriately at the gym with Mr. A on at least one occasion, and that he likely injured Mr. A while they were working out,” Wall said.

“I can’t say whether it was intentional, but in any case, I find it inappropriate behavior on the part of a caregiver in MB’s situation.”

A also claimed that after a night of drug use, B strangled him and threw him on a bed. B later said they had a pretend fight.

Wall said it was more than likely that “inappropriate physical contact” took place.

“Again, due to a lack of evidence, I am unable to determine the exact nature of this contact and the extent of the force used, but I believe that it demonstrates once again a blurring of professional boundaries between Mr B and Mr A.

“In my view, this was inappropriate behaviour on the part of Mr B and it made Mr A feel insecure.

“I also consider that it will always be inappropriate for a caregiver in a situation similar to Mr. B’s to play fight with the person for whom they are providing care,” Wall said.

“The aggression shown by Mr B towards Mr A is unacceptable in any circumstances.”

She said there was also evidence to support an allegation that B threw a piece of firewood at A in March 2020, injuring his leg.

“In my view there was a clear power imbalance and Mr B failed to maintain the professional boundaries imposed on him in his role as Mr A’s carer,” Wall said.

Wall found that B had violated the rights of patient A.

“I recognise that there were circumstances which may have influenced the blurring of professional boundaries between the two men, including the fact that they had a personal friendship spanning several years prior to Mr B’s employment with the disability service and that they were of similar age and had similar interests.

“This report highlights the problems that can arise when personal and professional boundaries become blurred and the group service provider does not have adequate processes and policies in place to manage the situation,” she said.

“The situation is further compounded when senior management lacks the skills and expertise to respond appropriately to incidents.”

Wall said she was “very critical” of the service’s operation as a residential facility and found the service had also violated patients’ rights.

She has forwarded her findings to the HDC’s Director of Proceedings, an independent lawyer, who will decide whether further action should be taken.

She also demanded an apology from B and the service’s administrators, even though it had closed as a residential facility.

The report states that the Ministry of Health conducted an audit of the disability service in 2021 due to A’s complaint.

The audit identified concerns regarding service to people with disabilities and made several requirements and recommendations for improvement.

A financial audit subsequently “identified areas of concern regarding its financial activities and non-compliance with its contract” with the ministry.

The ministry subsequently officially informed the disability service that it would not renew its contract when it expires in 2021.

Ric Stevens worked for many years for the former New Zealand Press Association news agency, including as a political reporter in Parliament, before moving to senior roles at various daily newspapers. He joined NZME’s Open Justice team in 2022 and is based in Hawke’s Bay.