Editorial: Clearer data on rest homes badly needed

Photo / NZ Herald

Documents for public consumption should be written succinctly and in plain English. Their value is much reduced if this is not done.

Over the past few years, there have been notable examples of a good standard of presentation, not least the easily understandable information on district health boards' targets.

But for every success, there have been glaring failures. Take the prospectuses for the part-floats of Mighty River Power and Meridian Energy, which were far too voluminous and almost impenetrable for the average mum-and-dad investor. Take also the Government's decision this week to publish, online, full rest home audit reports. In this case, the folly was exacerbated by the threat to remove these after six months if they were not being read.

This stand, taken by Associate Health Minister Jo Goodhew, defies logic. The audit reports will be read widely only if they are in a form that is readily accessible. But by Mrs Goodhew's own admission, those being released by the Ministry of Health are usually 100 pages and "quite technical". No attempt has been made to render them more comprehensible. The only changes are the removal of anything that might identify individual rest home residents. As such, both their length and complexity make them of very limited value for those seeking in-depth but comprehensible information.

The sole recourse for those wanting to gauge individual rest homes is the summaries of present and previous audits, which is also provided online by the ministry. These short documents include a useful traffic light-style presentation of benchmarks. They lack, however, much in the way of detail in areas of substantial interest, such as staffing ratios, trends in falls and pressure sores, and the number of complaints about the home.

It should be acknowledged that transparency has undoubtedly been enhanced by the Government's decision to publish the full audits, especially their release in tandem with a map that locates all of the country's 650 aged-care homes. At least, that is much improved from previous advice from the ministry, which suggested consumers should seek the audit reports under the Official Information Act. Unsurprisingly, given most people's lack of familiarity with this process, only 12 applications have been received.

But the improved transparency notwithstanding, the public should be far better served. The present shortcoming is hardly ameliorated by Mrs Goodhew's statement that she does not want to spend money on editing the audit reports unless people read them. More accessible information is the only way of addressing public unease about the standard of care being proved by individual rest homes. It is also the best means of persuading them to abandon substandard practices. Consumers will generally be right to conclude that compliance, as assessed by audit reports, is closely linked to customer satisfaction.

Further progress will be made in 2015, when it will be mandatory for rest homes to implement the United States-style International Resident Assessment Instrument. As Mrs Goodhew noted, this will identify "outliers", where individual rest homes have much higher rates of falls, pressure sores and other indicators of poor health.

Disappointingly, however, she has no plans to implement another important part of the US system operated by Medicare that enables people to find rest homes in any location and compare them under a star rating scale under several headings.

Taken together, the US initiatives provide the accessible and easily understood information that is missing in this country. In the interests of transparency and accountability, they should be adopted here as soon as possible. Nothing else will suffice if the Government is, as it says, always looking for ways to improve the certifying and monitoring of rest homes.