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Community care

Consumer empowerment

Respite centre self advocacy

Caregiver inadvertently leaves rude message on answerphone

Complaint about a reduction in hours

Getting the right wheelchair

Consumer with learning difficulty gets hospital liaison person 

Dealing with a rough caregiver

 

 

 

Consumer empowerment 

Home care agency ~ Right 5 ~ effective communication ~ Right 7~ informed choice & consent ~ Alzheimer's ~ EPoA

An advocate was contacted by a consumer who, while suffering from Alzheimer's, was still living in her own home. The consumer wanted support with issues of communication between the home care agency, her daughter and son. The daughter held the EPoA and all discussions and decisions were being made by the consumer's daughter and caregivers. The consumer's son had concerns about what was happening. As part of the discussion it became apparent that the EPoA was not enacted and that this was confirmed by a psychiatrist who had recently assessed the consumer. 

At a meeting with the consumer, she told the advocate she was being excluded from the decision-making process on a daily basis as the caregivers spoke with her daughter despite the consumer being present. The consumer lacked understanding about how an EPoA worked and thought this was how supported home care was meant to be. 

Upon being given the information about the Code and EPoA the consumer said she felt empowered to deal with the situation with the support of her son.

Two weeks later the  advocate contacted the consumer who had dealt very well with the situation. She had a new home care agency and was being included in communication, being given information and was making her own decisions. She had also written a response to what she considered an inappropriate comment made by a caregiver in her daily care book.  

The consumer and her son were extremely happy with the support and information provided by the advocate and requested the advocacy file be closed.

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Respite centre self advocacy

Right 5 ~ Effective communication ~  Right  10 ~ Complaint process ~ Respite care centre

An advocate was contacted regarding an incident that had occurred at a respite day activity centre and the way the complaint about the incident had been handled. The incident was a safety issue involving one consumer placing a plastic bag over the head of another. 

Upon addressing the concerns with management the complainant was advised the consumer who had taken the action was unaware of the danger due to their intellectual disability. As a result of this discussion a decision was made that the family member of the complainant would not attend the activity centre but the family still wanted to utilise the respite facility. The management of the facility declined the request and would not enter into any further communication.

The complainant felt that the management had handled the complaint in an unprofessional manner by refusing any discussion over the respite care issue, and not providing any alternatives.

After discussing how to progress the matter with the advocate, the complainant chose to write to the Trust Board responsible for the facility requesting the decision be rescinded and that the manager apologise for the way she had handled the complaint. 

The complainant later advised the advocate that she had received a "wonderfully written letter" from the Trustees and was very happy with the outcome. 

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Caregiver inadvertently leaves rude message on answerphone

Home based support services ~ Caregiver ~ Right 1 ~ Respect & privacy ~ Self-advocacy

A consumer with a physical disability led a full life in her own home, with support services in place. This had worked very well until recently.

The caregiver had phoned the consumer and left a message to say they would be a bit late.  However, the caregiver ontinued to talk on their own phone when the conversation had finished with the consumer. What the caregiver hadn't realized was they hadn't actually hung up the phone, therefore the answer phone had picked up the rest of the conversation.

This resulted in the caregiver being overheard talking about the consumer to a third party, identifying and sharing information about the consumer and being generally disrespectful.

The consumer tried to speak with the caregiver themselves by playing the message to them. The caregiver denied that this was what had been said.

The consumer became unsure about what to do so contacted the local advocate.

The advocate suggested to the consumer that an option was to have a meeting with the manager of the home-based support services to discuss and play the message. The advocate offered to support the consumer at this meeting should she want this. The consumer said she would prefer to have the support of the advocate if at all possible.

The provider rang in response to the consumer's complaint and request for a meeting and told the consumer when the meeting would be, without checking with the consumer whether this suited or not.

The consumer decided to go ahead and meet with the provider on her own after speaking with the advocate on how to approach the meeting. The consumer managed to talk with the provider, play the message and discuss how this had affected the consumer.

The provider wrote down the message in full, stated it would be typed up then given to the consumer to be checked and signed as true. Once that was done the provider would work with the caregiver.

At the end of the meeting the provider informed the consumer that a new caregiver would be assigned the following day. The consumer rang the advocate to let her know what had happened.  The advocate was able to congratulate the consumer on being an effective self advocate.

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Complaint about a reduction in hours

Needs Assessment Service Coordination (NASC) ~ Reassessment ~  Right 3 ~ Dignity & independence 

A consumer had a reassessment with a needs assessor from a NASC for people aged under 65. She was told that her hours would be reduced. The consumer was currently receiving 16 hours home help for cooking, cleaning and making her bed. These hours did not include any personal care in the weekends.

She was told that the NASC was looking at taking an hour off per day in the evening for meal preparation. The needs assessor told the consumer that she could just have frozen food, although she did not like frozen food and would need the current hours for meal preparation.

Before the needs assessor came, the consumer felt as though she had already decided to take the hours away from her.  Due to the consumer now having an orthotic for her inverted foot, she required extra hours to work out a way she could put the orthotic on independently.  

The consumer contacted an advocate to assist and support her with writing a letter of complaint to the NASC. After sending the letter of complaint to the NASC the consumer decided she would like to meet with the NASC to discuss her concerns.

The consumer contacted the NASC to organise a meeting with them which would take place at the consumer's house.  During this process the consumer kept the advocate informed as she wanted the advocate to attend and support her at the meeting.

A meeting was held at the consumer's house with the advocate and Quality Manager and Service Coordinator from the NASC. At the meeting the service coordinator outlined to the consumer that she would receive 20 hours home help a week, in order for the consumer to receive some home help in the weekends as well as well as assisting her with her orthotic.  

The consumer was happy with the outcome of the meeting and thanked the advocate for supporting her through the process. 

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Getting the right wheelchair

Wheelchair provider ~ Right 1 ~ Respect ~ Right 3 ~ Dignity and ndependence

A young, independent wheelchair user felt he had been unfairly treated by his wheelchair provider as his independence was permanently reduced by having to use an ill-fitting wheelchair.

The consumer had first been measured for his new wheelchair 12 months previous. The wheelchair came back too wide. However, he used the new chair for a couple of months, not realising the damage it was doing to his upper arms, so much so it resulted in him requiring cortisone injections.

Another measurement was eventually taken and he used a loan chair in the meantime. The consumer believed his new chair had been sent back to the manufacturer in Australia for the adjustments to be made.  He found out this was not the case. The damage to his upper arms worsened, further restricting his independence, as the loan chair was heavy, and difficult to put in his car. 

Because of the ill-fitting, heavy loan chair the consumer went back to using his old one, but this was unsatisfactory as it put pressure on his back and the foot rests no longer supported his feet. He had back pain and recurring chest infections from poor posture, and his independence and health were badly affected. 

The consumer contacted the advocacy service for support to meet with the wheelchair funding provider. The consumer was concerned the same mistake with the measurements would be repeated as he wasn't sure the provider understood the importance of taking correct measurements.

At the meeting the consumer explained to the provider his concerns and explained the profound impact on his life the poor measurements had made. The provider assured the consumer the correct measurement would be sent to the manufacturer in Australia that day and his new chair should be available within 6-8weeks.

The consumer was happy with the advocate's support. He felt he had been heard and the importance of a correct fitting chair was acknowledged. The consumer felt confident his chair would  be delivered to him in a couple of months and would contact the advocacy service if he required any more support.

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Consumer with learning difficulty gets hospital liaison person

DHB ~ Right 5 ~ Effective information ~ Right 6 ~ Fully informed ~ Learning difficulty

A consumer with a learning difficulty sought an advocate's support to write to a DHB to request a meeting with a doctor and some of the clinical managers.

He had frequent admissions to hospital and every time he was admitted with severe pain the staff had given him conflicting information. He said he was told he would be having an x-ray and when that didn't occur he was told it was due to his not being able to be found on the ward. At a later stage he was told it was because he had been lost in the system. He was then told he was to have an ultrasound scan followed by surgery but no-one had ever discussed a need for surgical intervention. 

At the meeting, with a support worker and the advocate present,  the consumer outlined the disparities in the information he was given by various staff members and how this had made him feel. 

Having listened to the consumer's concerns the staff apologised and agreed that in future the hospital would allocate one of their staff to be the liaison person with the consumer's support worker for any pre-arranged appointments, and in the event of any emergency admission, if that person was unavailable another person would be the single point of contact.

The consumer was very pleased with this outcome because he had been fearful of a return to hospital. 

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Consumer with learning difficulty gets hospital liaison person 
DHB ~ Right 5 ~ effective information ~ Right 6 ~ fully informed ~ learning difficulty
The consumer, who has a learning difficulty, sought the advocate's support to write to the DHB to request a meeting with a doctor and some of the clinical managers. He has frequent admissions to hospital and every time he was admitted with severe pain the staff had given him conflicting information. He said he was told he would be having an x-ray and when that didn't occur he was told it was due to his not being able to be found on the ward. At a later stage he was told it was because he had been lost in the system. He was then told he was to have an ultrasound scan followed by surgery but no-one had ever discussed a need for surgical intervention. 
He received a response to his letter agreeing to a meeting with the DHB personnel he had requested to be present. At the meeting with a support worker and the advocate present,  the consumer outlined the disparities in the information he was given by various staff members and how this had made him feel. 
Having listened to the consumer's concerns the staff apologised and agreed that in future the hospital would allocate one of their staff to be the liaison person with the consumer's support worker for any pre-arranged appointments, and in the event of any emergency admission if that person was unavailable another person would be the single point of contact. The consumer was very pleased with this outcome because he had been fearful of a return to hospital. 

 

 

Dealing with a rough caregiver

Caregiver ~ Rough handling ~ Right 4 ~ Consistent with needs

A consumer contacted an advocate because he was upset about the way a caregiver was treating and speaking to him. He felt the caregiver was rough, gave terse instructions, rushed through care and assistance, ignored him when he said he was dizzy and told him to "stop that silly nonsense". The consumer believed the dizziness was caused by the speed with which the carer moved him, as he did  not experience dizziness with any of the other carers.

After hearing the options presented by the advocate the consumer decided he would like a meeting with the manager. He and his wife wrote to the manager requesting a meeting with both the manager and recreation officer. The manager agreed to meet, suggesting it would be more appropriate for the head nurse to attend instead of the recreation officer.  

Prior to the meeting the advocate and consumer met to discuss and document the issues the consumer wanted responses for. These were forwarded to the provider along with information about what needed to be achieved to resolve the matter for the consumer.

The advocate supported the consumer at the meeting where he said he no longer wanted to receive care from that particular caregiver. Although the manager and head nurse acknowledged the consumer's concerns they were unable to accommodate his request as the caregiver was part of their regular staff numbers. The consumer accepted this and asked to speak with the caregiver directly to raise his concerns and clear the air. The meeting was adjourned for half an hour while the Manager spoke to the caregiver.

The meeting reconvened with the caregiver present. The consumer stated he wanted to resolve the matter with her so they could both move forward. The caregiver appeared distressed, but listened to and acknowledged his concerns. Each apologised to the other and decided they could move on together as a result of their discussion.

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