Tragic death of disability care client prompts criminal investigation

A disability care worker has been sacked and an investigation launched following the tragic death of one of her clients who died in “disgusting and degrading circumstances”.

 Ann Marie Smith, who suffered from cerebral palsy, passed away last month after being admitted to the Royal Adelaide Hospital with severe ulcerated and infected tissue and other serious illnesses that had developed while being cared for in her own home. The 54-year-old’s cause of death was identified as profound septic shock, multiple organ failure from severe pressure sores and cerebral palsy, while she had also suffered from malnutrition.

After being made aware of the shocking situation, investigators from SA Police attended Ann’s home in the Adelaide suburb of Kensington Park and found her living conditions to be unacceptable. An investigation has since been launched as a result of a complaint made to the Health and Community Services Complaints Commissioner about the level of care provided to Ann.

“Ann lived alone and had a full-time carer and was unable to walk or take care of herself,” Detective Superintendent Des Bray said. “Despite living in a nice house, Ann died in disgusting and degrading circumstances. This is a tragic case.”

Ann’s carer, who was employed by Integrity Care SA, has since been sacked by the organisation, with the NDIS provider claiming they had been investigating the worker prior to Ann’s death. In a statement released shortly after Ann’s death they said they were “completely misled by her [the carer]” and were “shocked and appalled” by the situation.

“In this regard, prior to the SAPOL announcement on Friday, we already had been conducting our own intense investigation and are continuing to work closely with the NDIS,” the statement read. “It’s important to report three matters arising from the initial investigation. First, we have already performed welfare checks on every other person with whom Ms Smith’s carer had any involvement and all those individuals are in good health.

“Second, we have also appointed an independent expert to review every NDIS participant in our care, including those participants looked after by Ms Smith’s carer. Third, we interviewed Ms Smith’s carer as part of that investigation and suspended her pending notification on the cause of Ms Smith’s death.”

The tragic case has raised many questions by the police, health officials and the community. It’s also prompted those with loved ones are currently receiving in-home care to question how they can be confident the care being provided is what was promised.

Geoff Rowe, chief executive officer of Aged and Disability Advocacy Australia (ADA Australia), described Ann’s death as “shocking” and said generally, disability and aged care providers go above and beyond to ensure the care of clients is up to standard. He said there are many unusual factors surrounding Ann’s case, such as why the infections had been left untreated for so long and why a complaint hadn’t been made earlier.

Government funded and approved providers are required to meet annual quality certification checks and in some states and territories, such as Queensland, further welfare checks are undertaken by the Office of the Public Guardian. Meanwhile, Rowe said a good provider would usually undertake their own checks on staff members to ensure client needs are being met. And as a further concern, Rowe said if the worker in question was Ann’s only carer, that is quite unusual.

“Having one person being effectively the full-time carer, in my view is quite unusual, that’s one of the alarm bells that’s there,” he said. “Sometimes it happens in rural and remote communities due to staff shortages but in a place like Adelaide it’s quite unusual and it doesn’t add up at any level. It’s not good practice and could leave someone quite vulnerable.”

However, Rowe said there’s some responsibility of the family to also ensure their loved one is receiving appropriate care. This could mean popping in for regular visits, calling to check-up or if they’re living interstate, arranging for a neighbour or friend in the community to visit their loved one regularly. Police can also carry out welfare checks or a doctor can be arranged to visit the property for a health assessment.

And it’s important to note that home care clients do have rights when it comes to the services provided. The Australian Competition and Consumer Commission (ACCC) outlines a person’s rights under the Australian Consumer Law, which are in addition to the rights under the Aged Care Act. The government agency has a series of guides to help Aussies understand what these rights are and what can be done if the care received isn’t up to standard.

While initially home care packages (HCP) were a rigid system, since 2017 Aussies have had complete freedom when choosing a care provider to suit their needs, right down to choosing what services they receive and what to do if they’re unhappy with the level of service being provided. If a family has concerns the care provided to their loved one is below standard, providers generally have a thorough complaints process set up to assist clients and their families. It then becomes the provider’s responsibility to follow up this complaint and action any changes deemed necessary.

But, if a client and their family feels the complaint isn’t being considered and the issue hasn’t been resolved, a complaint can be raised to the either the Disability Quality and Safeguards Commission or the Aged Care Quality and Safety Commission, depending on what service is being provided.

“Organisations such as ADA Australia can also assist by being an advocate to a family and assisting them with the complaints process,” Rowe said. “They can help give people a voice, provide information and help them understand what their rights are.”

Sadly, for Ann it’s too late, with the investigation into her death ongoing. However, action is being taken to understand what went so terribly wrong. Last week provider Integrity Care SA was issued an infringement notice and fined $12,600 by the NDIS Quality and Safeguards Commission for failing to notify them of Ann’s death.

As a registered NDIS provider the organisation was required to notify the commission of her death within 24 hours of becoming aware of it. However, two weeks passed before they were informed of the tragic news. Commissioner Graeme Head said there were “clear failings” in the support given to Ann and the NDIS are working in close contact with the police to uncover the tragedy that occurred.

“The NDIS Commission has already issued a compliance notice to Integrity Care requiring them to do a range of things to protect the safety of other people with disability that they support,” he said. “We have also required their full co-operation with an audit against the NDIS Practice Standards.”