The Ministry of Health investigated the residential home after a complaint was made about the carer to the Health and Disability Commissioner (HDC).
The ministry then cut its funding to the charitable trust running the service after the audit raised concerns about its service and finances.
“The trust is no longer in operation,” according to an HDC report released on Monday.
The name of the disability service and its location, and the names of the carer and client, were redacted from the report by Deputy Commissioner Rose Wall.
The client was named Mr A and and the carer Mr B, who was employed part-time by the service between 2017 and 2020 and had previously been a friend of the man who came into his care.
Wall said she found the concerns raised by A about B’s behaviour towards him to be “very serious” but it was difficult to verify what happened because of conflicting information.
Her ability to make findings of fact was also hampered by “the disability service’s lack of independent investigation and contemporaneous documentation of these concerns”.
Wall said it was not disputed that A and B consumed alcohol together. She said this was inappropriate, even if it happened when B was off-duty.
Wall said she was unable to make a finding about the alleged consumption of cannabis as there was almost no evidence available apart from A’s allegation that he was pressured to do so.
“However, if true, I would also be extremely critical of this,” Wall said.
She was also unsure about a video which B showed to A, of another of the service’s male clients allegedly holding a sex toy.
“I am unable to make a finding on whether the video was of a resident eating chocolate or of a pornographic nature,” Wall said.
“Regardless of the content of the video, it is generally unwise for providers to show consumers content from their personal devices, especially when the content involves humour at another consumer’s expense.”
A’s complaint, made with the help of his independent psychologist, referred to various incidents where he said B had been violent towards him.
These included punching him at the gym, and throwing a piece of firewood at him.
A said that B had used him as a “punching bag” at the gym and he informed the disability service about this but it was not investigated.
B told the commission that A did join him at the gym and that the men took turns holding pads while the other punched for boxing practice, and he said it was possible he had hurt A.
The service said that it had investigated an incident at a gym in 2019 when B was “making fun of Mr A and videoing him to show his friends”.
“I consider it more likely than not that Mr B acted inappropriately at the gym with Mr A on at least one occasion, and that he likely hurt Mr A while they were training,” Wall said.
“I cannot say whether this was intentional, but in any event, I find it to be inappropriate behaviour from a carer in Mr B’s position.”
A also alleged that after a night of substance use, B put him in a choke hold and threw him on a bed. B said later they had been play-fighting.
Wall said it was more likely than not that some “inappropriate physical contact” had occurred.
“Again, owing to a lack of evidence I am unable to ascertain the exact nature of this contact and the extent of force used, but I consider that again it demonstrates a blurring of professional boundaries between Mr B and Mr A.
“In my view, this was inappropriate behaviour by Mr B and resulted in Mr A feeling unsafe.
“I also consider that it will always be inappropriate for a carer in a similar position to Mr B to play-fight with the person to whom they are providing care,” Wall said.
“Aggression shown by Mr B toward Mr A is unacceptable in any circumstance.”
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 that were required of him in his role as Mr A’s carer,” Wall said.
Wall found that B had breached A’s patient rights.
“I acknowledge that there were circumstances that may have influenced the blurring of professional boundaries between the two men, including that they had a personal friendship spanning several years prior to Mr B’s employment at the disability service and that they were of similar age and had similar interests.
“This report highlights problems that can occur when personal and professional boundaries become blurred, and the group provider does not have adequate processes and policies in place to manage the situation,” she said.
“The situation is further compounded when senior management staff are not equipped with the skills and expertise to respond to incidents appropriately.”
Wall said she was “very critical” of the service’s operation as a residential facility and found that the service had also breached patient rights.
She referred her findings to the HDC’s director of proceedings, an independent solicitor, who will decide if further action should be taken.
She also demanded apologies from B and trustees of the service, even though it had closed as a residential facility.
The report said that the Ministry of Health conducted an audit of the disability service in 2021 because of A’s complaint.
The audit identified concerns about the disability service and made several requirements and recommendations for improvements.
A financial audit then “identified areas of concern about its financial activities and non-compliance with its contract” with the ministry.
Subsequently, the ministry formally notified the disability service that it would not renew its contract when it ended in 2021.
Ric Stevens spent many years working for the former New Zealand Press Association news agency, including as a political reporter at Parliament, before holding senior positions at various daily newspapers. He joined NZME’s Open Justice team in 2022 and is based in Hawke’s Bay.
