Provision of assistance with medication administration - 17HDC01168

Deputy health and disability commissioner Rose Wall today released a report finding a home support agency in breach of the Code of Health and Disability Services Consumers’ Rights for failings related to the support its support worker provided to an 87-year-old woman.

The home support agency was contracted to provide the woman, who lived in her own retirement village apartment, with residential support, which included administering warfarin.

The support worker was engaged to provide support to the woman, as the woman’s regular support worker was unwell. The support worker had not had any medication training or competency checks in 10 years, and had not received the training required for support workers to oversee clients taking warfarin, as outlined in the home support agency’s warfarin policy.

The support worker was given a handover over the telephone, but was not given instructions on where to find the woman’s medication box, or on the administration of warfarin. She did not administer the warfarin on her second and third day of providing support, and failed to alert the home support agency’s call centre of this.

A few days later the woman was admitted to hospital with an ischaemic left leg and required surgical intervention. The ischaemia was thought to have been caused by her missed doses of warfarin.

The woman’s daughter made several complaints to the home support agency – both verbal and written – regarding the failure to administer warfarin; however, she did not receive a response.

Ms Wall considered that the home support agency failed to provide the support worker with the training required to administer warfarin according to its own policies, and failed to provide her with clear handover instructions. Ms Wall also noted that the woman’s son had highlighted the issue of missed medication with the home support agency on two previous occasions and it failed to improve its services in light of these concerns. Ms Wall found that the home support agency did not provide services to the woman with reasonable care and skill.

Ms Wall also made adverse comment regarding the home support agency’s complaints management system, and the support worker’s failure to notify the call centre when she did not provide the woman with her warfarin.

Ms Wall made a number of recommendations to the home support agency around the training of its support workers, the auditing of its new system for selecting appropriately skilled support workers, and the development of a new formal handover policy. Ms Wall also recommended that the support worker and the home support agency provide an apology to the woman’s family.