Master A was living in a residential facility run by Brackenridge Services and required support for his complex needs, including physical and intellectual disabilities. Photo / 123RF
A disability support worker said conduct from a colleague toward a young man with complex needs felt like “she was witnessing child abuse” when the patient was yelled at and dragged by his feet.
Brackenridge Services was found to be in breach of the Code of Health and Disability Services Consumers’ Rights in a report released today by Deputy Health and Disability Commissioner Rose Wall.
The young man, referred to as Master A, had intellectual disabilities, was non-verbal, and had physical health problems including epilepsy, cerebral palsy and cortical visual impairment.
He used a wheelchair and expressed his needs by showing and pointing, using body and facial expressions, and using a tablet with pictures, the decision said. His support needs were described as complex.
Wall found Brackenridge, an organisation that provided residential support to patients with disabilities and autism, had breached the code by failing to provide information about physical intervention in Master A’s individual support plan and not reporting the allegations of what she considered abuse.
“As a facility responsible for supporting residents with a range of complex and extremely challenging behaviours, it is important that Brackenridge provide its staff with adequate guidance and training on how best to respond to inevitable challenging behaviours,” Wall said in her decision.
Her findings come after an incident in November 2019 when Master A was living in a residential facility with two others, including another patient with complex needs.
He was unable to attend school that day and additional support was needed at the home, including that of the support worker whose conduct was reported to the HDC.
The support worker, referred to as Mr D, had worked with Master A three years prior to the incident and had informed Brackenridge he found working with the young man difficult in the past.
On the day of the incident, Master A was attempting to climb the fence of the home “to go out”.
Mr D was working with another support worker at the time, Ms E, and told her to leave him because he would go outside again and according to the decision said, “he was unable to climb the fence anyway”.
He then told Ms E to “just pull him down, no one will see you”, however, Mr D denied he said this.
A third support worker, Ms C, was working in a residence nearby when Ms E told her about what was happening.
When she arrived at the house Master A had climbed the fence and was shuffling toward the road.
Master A was aggressive at this stage and Mr D was speaking to the young man in a “gentle tone” before he picked him up under his arms and supported him home.
The same day Master A was in the kitchen trying to use the food processor when Mr D yelled at him to get out and go to the dining area.
According to Mr D he needed to use a raised voice with the resident at times, and said he was trying to calm Master A down by raising his voice.
When Master A kept returning to the kitchen, Ms E said Mr D grabbed the boy.
At one point she alleged Mr D “pulling Master A’s feet and dragging on the floor and ... putting his full weight on his body.”
He denied this and said as a third-year nursing student he knew putting pressure on Master A’s body would drastically compromise his bodily function.
Mr D said he believed the incident didn’t need to be reported, and no other support workers reported the incident to Oranga Tamariki, who were the guardians of Master A.
He did, however, admit some aspects of his care “could have been better”.
Two days later Ms E reported the incident to her bosses, and said she felt she “was witnessing child abuse”.
Oranga Tamariki were made aware of the complaint when Master A’s social worker had a meeting with Brackenridge around three months later.
The incident should have been reported by Brackenridge within the hour of Ms E’s complaint, Wall said, and formal paperwork should have been completed.
Wall said the service provided by Brackenridge to the young man failed to ensure his individual support plan included information about when physical restraint could be used.
She said this meant the services were not delivered with reasonable skill and care and were in breach of the Code, and she found Mr D and Ms E didn’t have adequate training.
Brackenridge was also in breach when they failed to inform Oranga Tamariki about the incident.
Recommendations from Wall included making sure all individual care plans had clear guidelines on how to manage various situations and all managers were aware of approved physical interventions as well as adequate training for support workers.
Wall also ordered an audit of all complaints received during the past six months to make sure OT was aware of complaints within an appropriate time.
Because of the incident, Brackenridge had made several changes to their services, including reminding service managers to make sure all support plans were formally authorised by Oranga Tamariki.