Allegations of poor care, patients left unclean for hours at a South African government-run disability care ward

A man living in a state-run disabled care facility would rather risk his life than have his leg amputated for fear of not being treated properly.

Mostyn Evans had his left leg amputated last year due to vascular disease.

Now doctors say his other leg also needs to be removed, but Mr Evans refuses to let it happen.

He made the decision to put his life at risk due to concerns about the quality of care he and other residents received at Transition to Home, run by the state government at Repat Health Precinct in south d ‘Adelaide.

“I don’t want to end up there, I haven’t received the level of care I deserve as a basic human right,” he told the ABC.

Mr Evans has lived there since February 2022.

It was opened in September to support NDIS-eligible patients while they await long-term accommodation.

But Mr Evans said he and other residents suffered a lack of timely and proper care, and often saw immobile patients getting dirty while waiting for a carer to take them to the bathroom.

“I don’t want to lay there and shit myself if I need to go to the bathroom.

“I want to go to the bathroom, but it won’t happen there.”

He said another client’s catheter bag was also left full on a regular basis, which eventually led to a bladder infection.

Mr Evans said he had several other concerns, including medical consultations held in communal areas and the administration of incorrect drug dosages.

“I was given another client’s medication, and I was also given the wrong dose of medication in regards to my medications,” he said.

Inappropriate care

Mark Kinsley said he shared the same concerns. His wife Nadine, who lives with early dementia, is also at the Repat establishment.

He said that Nadine had been in her own feces several times for hours.

“It’ll be on his hands, it’ll be on his clothes, it’ll be on the sheets and, and it’ll be dry, so it’s not like it just happened,” he said.

“I’ve been here for five hours… and the lady who was in front of Nadine, nobody checked her in five hours.

“Sometimes she would call ‘is anyone there? — and I should go find him a member of staff.”

Mr Kinsley said that until he raised his concerns with staff his once vibrant wife was also chemically restrained with medication which should only be used in exceptional circumstances.

“She was always sleepy, she couldn’t get her out of bed,” he said.

“When you got her out of bed, it was, she’d been up for 15 minutes [and would say] ‘I’m tired, I’m going back to bed'”.

He said that on another occasion, carers didn’t realize his toenails were ingrown.

“It was only recently, because she always wears socks, that the carer took her socks off and noticed that her fingernails had grown into the bone, so she was walking really badly.”

Mr Kinsley said while many carers were fantastic, some did not seem to have the training and attention to detail needed to care for Nadine adequately.

“Some of them are fantastic, they do everything, and then there are some who do little,” he said.

Watchdog previously criticized the installation

In February, the Complaints Commissioner for Health and Community Services criticized the Transition to Home’s Hampstead campus for its care of a patient, “Mr. D”, who was left for “prolonged periods”…”in the faeces and urine”.

The commissioner’s report made 12 recommendations, including the assignment of a nurse clinician as a “health monitor” to regularly check on the well-being of patients.

Social Services Minister Nat Cook said the director of nursing fills the role, while the department recruits someone full-time.

Having heard residents’ concerns while in opposition, Ms Cook also commissioned an expert review of the facility when she took office earlier this year.

“None of these reports are what we should hear in a first-world country with excellent healthcare systems.”

She said she had just received her findings, which would be made public alongside a ministry response in mid-August.

The minister said the initial findings of the report revealed the failure to put in place a proper governance structure at the start of the programme.

“The first things I’ve seen are a failure to put in place the proper governance structure and mechanisms, acknowledging that this site has received contributions from health, contributions from [Department of Human Services] and input from NDIS service providers,” she said.

“I think this is something that will need to be addressed urgently to ensure that there are pathways for an appropriate communication structure where there are consistent policies and protocols.”

Essential care for patient well-being and the whole system

The social services minister said getting people out of the transition into care was key to easing pressure on the hospital system, which was already overstretched due to the pandemic.

“On July 22, there were 125 NDIS participants in our public hospitals who were ready to be discharged, who no longer required hospital care or clinical interventions,” Ms Cook said.

“And more than half of them have been blocked for more than 100 days.”

Ms Cook said she was committed to reducing the time residents spent on Transition to Home and, where possible, removing the need for the service altogether.

“I want to see people with a discharge plan going into the hospital and leaving the hospital to go home. Home,” she said.

She said that currently people stay far too long.

“People had to go to these places for up to 90 days on average,” she said.

“The average length of stay in transition to home is around 200 days, I can confirm that some people have been there for over a year.”

For Mostyn Evans, the urgency is much more personal.

Nadine Kinsley’s husband, Mark, agreed.

“Having full-blown dementia where she doesn’t even know who I am anymore, so for all of this to happen, it’s not her fault,” he said.

“She shouldn’t be treated the way she was treated, none of these people should, they are human beings.”