The Deputy Health and Disability Commissioner is calling for stronger oversight of the treatment of disabled people living in care, after a report revealed disturbing issues including the use of restraint and force.

The report by Rose Wall looked at 363 complaints to the Health and Disability Commissioner about residential disability support services over five years.

It found a range of problems, including the use of restraint and force, unsafe medication management, poor management of health conditions, and failure to follow support plans.

It detailed examples of HDC complaints, including one in which a man with cerebral palsy died from a brain injury after choking on his food, which had not been cut up for him, despite his support plan stating it must be.

In another, a whānau member reported "... (a staff member) physically restraining residents in a violent manner, overpowering them during incidents … This is extremely concerning, particularly as (the provider is) aware of these incidents but appear(s) to show an alarming lack of concern of the physical harm that may result, and the scarring psychological impact on those being restrained."

The report also highlighted that people were scared to speak up for fear of backlash from their carers, or losing their support, Rose says.

Among her recommendations was that Whaikaha, the Ministry for Disabled People, should create a "quality framework" that sets clear expectations for standards of care, and improves proactive monitoring and reporting.

"There needs to be a mechanism by which we are alert to disturbing issues, and that we're monitoring the system, and having a way of gaining feedback from people who are using disability support without being reliant on complaints being brought to our attention," she says.

It should be easier for people to raise concerns, and they should not be worried about doing so, Rose says.

The report found workforce shortages and a lack of funding contributed to the problems.

Rose says she would be monitoring the sector's response to her recommendations.

The report's findings

The HDC identified several themes that highlighted "areas of concern". These included:

• Failure to adhere to support plans

• Inadequate standards of care, including poor medication management, poor identification and management of health conditions including deteriorating health, and poor oversight and supervision of staff

• Use of restraint and force

• "One-size-fits-all" approaches to individual disabled people's needs

• Lack of culturally safe and appropriate support services

• Poor coordination with other services, including health services

• Poor communication with disabled people and their whānau that is not respectful or culturally appropriate

• Skilled staff shortages

• Poor responses to feedback and complaints, including fear of retaliatory behaviour from staff and management

-RNZ