Report on an announced inspection of Ward Older Persons and Rehabilitation (OPR1), Waikato Hospital

Excerpt: Inspection approach

From 6 to 9 June 2023, three Inspectors made an announced four-day inspection of Ward Older Persons and Rehabilitation (OPR1, referred to in this report as the Ward). The Ward is located on the Waiora Waikato Hospital Campus, and is managed by the Te Whatu Ora Waikato Mental Health Service for Older People (MHSOP). 

The Ward is a 15-bed, mixed-gender facility for over 65-year-olds which provided care to three cohorts of tāngata whai ora. This included care for tāngata whai ora who require: 

• acute mental health treatment,
• assessments with a recent onset of psychiatric illness or who had complex behavioural and psychological difficulties associated with dementia,
• palliative care.

Tāngata whai ora may be admitted under orders made under the Mental Health (Compulsory Assessment and Treatment) Act 1992 (MHA), or on a voluntary basis. 

There were 15 tāngata whai ora on the Ward on the first day of inspection; nine were male and six female. Seven tāngata whai ora were voluntary admissions, while eight were under MHA orders. 

Voluntary tāngata whai ora are under no legal compulsion to remain within a facility to receive mental health services. However, where there is a risk that arrangements in place could effectively mean voluntary consent is not given (including to treatment) or they are not free to leave at will, voluntary tāngata whai ora come within the scope of my OPCAT function. 

Inspectors gathered and assessed a range of information, including reviewing documents, interviewing a number of people, and observing Ward activities. This included observations that tāngata whai ora were respected as individuals, and that tāngata whai ora were positive about the care they received.

Inspectors observed that staff were highly engaged with tāngata whai ora through conversations and tailored care. Staff spent the majority of their time actively supporting tāngata whai ora on the Ward. Tāngata whai ora were treated with dignity and respect by staff, for example by knocking on doors before entering bedrooms. Tāngata whai ora expressed gratitude to the nurses for their kindness during staff and patient meetings.             

I am pleased that tāngata whai ora individual preferences were respected, and thoughtful attention and care was provided by staff, which helped tāngata whai ora feel valued.

As a result of my inspection, there were several observations which have led me to make recommendations to Ward Management and Te Whatu Ora in relation to the conditions and treatment of tāngata whai ora.

My provisional report was sent to Te Whatu Ora for their comment. I received a response from them stating ‘we have no comment or feedback to provide on the provisional report’.