Balclutha rest-home resident left with ‘smelly and infected’ wounds in weeks before death

A vulnerable resident at a Balclutha rest-home was left to suffer with “smelly and infected” wounds on both her legs in the weeks before her death. The revelations concerning 61-year-old Mrs A’s experience at Clutha Views Village emerged in a Health and Disability Commissioner report prepared by deputy health and disability commissioner Rose Wall, and published on Monday. Clutha Views is owned by residential aged care provider Heritage Lifecare, which operates 42 care homes and 20 villages nationwide. The situation arose after Mrs A entered Clutha Views to convalesce on February 22, 2022, following hospital treatment for a leg wound caused by her dog’s claws. Despite Clutha Views receiving clear instructions Mrs A’s wounds were to be re-dressed twice a week, “it is evident this did not occur”, the commissioner’s report said. Matters came to a head on April 3, when it was noted Mrs A was having trouble breathing, and nursing staff contacted local physician Dr B, seeking permission to give her oxygen. Clutha Views nursing staff also told Dr B that Mrs A had had some difficulty swallowing for the past two weeks, had not been eating much and had little urine output. When Dr B reviewed Mrs A at the facility, she found “very smelly and infected wounds on both her legs” and that one of the dressings had not been changed for 10 days. The doctor also noted that Mrs A’s urine was opaque and grey. Mrs A’s drop in urine output two weeks earlier had not been reported to the GP. Dr B considered that Mrs A’s deterioration and the state of her dehydration and highly concentrated urine could not have happened solely over the course of that morning. The doctor said she was surprised not to have been called earlier, and Mrs A’s overall state of health during her visit was “markedly poor”. A few days later, in “early April 2022”, Mrs A was diagnosed with renal failure and sepsis and died. Although the report did not draw a causal link between the deficits in her care and subsequent death, it criticised Clutha Views for providing “suboptimal healthcare services” to the resident. “The issues outlined above reflect systemic failings in the delivery of care to a resident with a complex medical history, high needs and at particular risk of deterioration. “The absence of consistent, co-ordinated and responsive care fell well below accepted standards and is deeply concerning.” Heritage Lifecare was found to have breached the Code of Health and Disability Services Consumers’ Rights, and instructed to address issues identified. These included improved staff training, and submitting to further commissioner oversight to ensure all issues were remedied. Heritage Lifecare said it did not challenge the report’s findings, and had reviewed training and policies in the wake of the incident. In a statement provided to the Otago Daily Times a spokesperson said: “We acknowledge there were shortcomings in elements of care and have apologised to the family. “We have taken the concerns raised seriously and have implemented recommended actions to address the issues identified.” richard.davison@odt.co.nz