“Staff assaulting patients”: Govt to shut down Oakden mental health facility

The South Australian government is to close a state-run elder mental health facility in Adelaide after the release of an independent investigation into the “reprehensible” treatment of patients.

Apr 20, 2017, updated Apr 21, 2017
Then-Mental Health Minister Leesa Vlahos (centre-right) next to SA Health CEO Vicki Kaminski, answering journalists' questions following the release of the Oakden Report.

Then-Mental Health Minister Leesa Vlahos (centre-right) next to SA Health CEO Vicki Kaminski, answering journalists' questions following the release of the Oakden Report.

Mental Health Minister Leesa Vlahos says residents at the Makk and McLeay nursing home at Oakden will be moved to alternative mental health or aged care facilities over the coming months.

Vlahos told reporters at a press conference this afternoon that the treatment of patients at the facility had been “reprehensible”.

“I have offered an unconditional apology to past and present consumers at the Oakden facility today,” she said.

“There was a culture of cover-up amongst some of the staff at this facility.”

Vlahos was repeatedly pressed by reporters about the State Government’s responsibility for the conditions at Oakden, about which concerns had been raised as early as 2001.

But she said the Government was now acting decisively. She reiterated her apologies and that there had been a “culture of cover-up” at the facility.

Eight staff have been stood down pending a full investigation, 21 have been reported to the Australian Health Practitioner Regulation Agency and three incidents have been reported to police.

It follows the release this afternoon of a damning independent review of the facility by Chief Psychiatrist Dr Aaron Groves.

The review heard reports of “grossly inappropriate conduct” of Oakden staff, including:

  • “Staff assaulting consumers (patients).”
  • “Aggressively washing a consumer’s genital areas.”
  • “Staff threatening the wife of a consumer.”
  • “A staff member asking a female client ‘to paint their toenails’.”
  • “A staff member with a drug problem. Found with a fentanyl patch for personal use.”

Relatives and carers told the review their loved ones had suffered appalling mistreatment:

“I am taking my Mum to the dentist, last time she went she had shit in her hair and on her hands and on the chair – they should be ashamed of themselves, how can they call
themselves nurses.”

“Are all the staff replacing these experienced staff suitably qualified – my Mum two years ago had a male catheter tried to be inserted into her for 2 hours for a urine specimen – she was screaming for 2 hours.”

“When I asked about showering and bathing I was advised that it is only every four days and a wipe down in between. I asked them if it could be done every other day. Now he has to have a bath and it is once every 4 days.”

The review finds that there had been “ongoing, repeated use of restrictive practices at Oakden that has likely contravened legislation, national standards, state policy and local procedures, and likely implemented for staff convenience or punishment”.

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There were “unacceptably high levels of challenging behaviour; worrying data on increased use of restraint, falls and other injuries; medication errors; and as shown elsewhere assaults and poor clinical outcomes”.

“Despite all the evidence, there has been a failure of staff at all levels, particularly senior levels, to ask why?

“The review found that in many ways, it had become a situation of people taking aim at others they perceived to be responsible.

“The result had been a circular firing squad with no one working to solve the problem.

“Many have stood by, incurious and disinterested, and watched it happen.”

The review found more than a dozen findings of a 2008 report into the facility had not been addressed and were also found by the review released today.

The findings included:

  • “KPIs not routinely monitored, therefore no oversight of key clinical processes relevant to the population.”
  • “Data on skin integrity, falls, episodes of aggression, infections and medication errors not used in a cycle of continuous improvement.”
  • “Management of behavioural disturbance is a low priority as the resolution of these behaviours and subsequent discharge is not seen as a realistic goal.”
    “No sense that behavioural management was a primary focus and some people had not been seen medically for 5 years.”

The Chief Psychiatrist’s review describes a widespread practise of “floor time” at the facility, in which staff would leave patients “on the floor in considerable distress if they had formed a view that intervening to assist the person was not needed immediately, for whatever reason”.

“This is among the most abhorrent approaches to providing care to severely disturbed consumers that any of the Review had encountered in well over 110 years of collective practice.

“It simply lacks any humanity.”

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