South Australia's health complaints watchdog has delivered a scathing assessment of a state-run disability care program, after one of its clients was found by ambulance staff in squalid conditions and with an infected wound.
Wearing clothes soiled by faeces and urine, the man was in a state of malnourishment and had a "dirty moist towel" covering a wound on his neck and jaw when ambulance staff responded to a triple-0 call at the Hampstead Rehabilitation Centre in Adelaide's north-east on May 31 last year.
The South Australian Ambulance Service (SAAS) later made a formal complaint to the Health and Community Services Complaints Commissioner (HCSCC) about the case.
The man, who uses a wheelchair and is referred to in the report as "Mr D", was a participant in the Transition to Home program which is run by the SA Department of Human Services (DHS).
The T2H program provides short-term temporary accommodation for people with disabilities awaiting permanent housing, after being discharged from hospital.
Commissioner Grant Davies today issued a damning report into the case which, he said, exposed "failings in hygiene, wound care and weight monitoring".
The revelations come amid a royal commission into disability care, and less than two years after the case of Ann Marie Smith was exposed.
Associate Professor Davies made 13 recommendations including around improvements to hygiene care, including that "regular assessment" be undertaken.
"Poor communication led to a poor outcome in this case and this is something that must improve across the entire health and community services sector."
According to the report, the client was admitted to the Royal Adelaide Hospital on January 22, after suffering a fall outside his family home.
He was transferred to another facility in April and then to an available bed at the T2H facility at Hampstead in May.
"On 27 May 2021, it was reported there was yellow puss coming from the wound on Mr D’s neck and that it smelled and looked infected," the report stated.
"Client Progress Records indicate Mr D was not showered on any occasion while at T2H and only received bed baths."
Ambulance records indicate that Mr D was "left in faeces and urine [for] prolonged periods of time, with a dirty moist towel over [an] infected wound site".
Associate Professor Davies wrote that the department was taking his recommendations "seriously" and endeavouring to implement them.
"I have made 13 recommendations in the report aimed at ensuring consumers are being adequately cared for, that all of their needs are being met, that their care plan is being followed and to take immediate remedial action if they are not," he said.
"I am pleased these recommendations are being taken seriously by DHS and either have been implemented or are in the process of being implemented. This should avoid the type of situation happening in the future."
Associate Professor Davies also recommended T2H apologise to the client and his family "for the inadequate care he received".
In a statement, DHS chief executive Lois Boswell said the department had "accepted the Commissioner's findings and is genuinely sorry that the client did not receive the level of support and care expected".
Human Services Minister Michelle Lensink has also been contacted for comment and, in a statement, a government spokeswoman conceded "T2H failed the client and did not meet the required benchmarks".
"As recommended by the Commissioner, DHS has immediately actioned new processes and systems to ensure the quality of care at the T2H service meets required standards."
Ms Lensink did not front the media, but Health Minister Stephen Wade and Premier Steven Marshall both apologised for how the man was treated.
Mr Wade said the case was "a world of difference from Ann Marie Smith" since it was the man's medical needs that were overlooked not his personal care needs.
"What the commissioner's report has highlighted is the Department of Human Services needs to make sure they've got line of sight of the medical needs of their clients, not just the personal care needs of the client," Mr Wade said.
"The Department of Human Services completely acknowledges that and is in the process of fixing it."