Rosa Maria Maione, the Adelaide disability support worker who killed her client Ann Marie Smith, is now behind bars, with the judge also to find her NDIS provider and the NDIS culpable.
Ms Smith died in April 2020 from severe septic shock, organ failure, pressure sores, malnutrition and other complications from her cerebral palsy.
The 54-year-old lived alone in her Kensington Park home and relied on an NDIS support worker for all of her needs.
That support worker — Ms Maione, 70 – pleaded guilty to Ms Smith's manslaughter last July.
During sentencing submissions on Thursday, the Supreme Court heard Ms Smith died from a 15-centimetre bedsore on her hip that became infected after it was left untreated.
The court heard she had “wasted away” and her hip bone was visible.
The court also heard the cane chair Ms Smith used as a toilet had started to decompose due to human excrement, and that Ms Smith had not received care for months before her death.
“She was not properly fed, she was not properly bathed, her teeth were not properly cleaned,” prosecutor Lucy Boord SC told the court.
“There was very little of her daily care that was attended to at all.
“The question has to be asked what did she do for all that time at (Ann Marie Smith's) house?”
Maione's bail was revoked with the court hearing she would be deported to Italy upon her release from prison.
'Animals treated better', family tells court
Through his victim impact statement, Ms Smith’s brother Steven told the court that it haunted him to think of his older sister “rotting away in her cane chair that used to be her safe haven”.
“My parents had set Annie up financially in a beautiful house with 24-hour care in preparation for when they could no longer be here to care for her,” he wrote.
“The thought of their biggest nightmare coming true continues to tear me up inside.
"We hope that there are protocols put in place and consequences so that no other person with a disability relying on support from others has to go through what Annie has."
Ms Smith's uncle, Glen, told the court “animals were treated better” than Ms Smith was.
“Rosa Maione allowed a completely vulnerable person like Annie, another human being, to sit in squalor, excrement, not fed, not toileted, not washed, just left like a bit of road kill,” he wrote in his victim impact statement.
Mr Smith said he had become estranged from his sister because she put "what she thought was a valued friendship" with her support worker before her family.
Maione's lawyer Stephen Ey said the court should take Mr Smith's victim impact statement with "a grain of salt" and to disregard some of it as it was "really unhelpful".
"Where were they? Where were [the family] over a number of years?" Mr Ey asked the court.
But Ms Boord SC told the court Mr Ey’s comments were “offensive” and “not the point of a victim impact statement."
'I talk to Annie every day'
Maione apologised to the court and said she prayed for forgiveness "every day".
“I’d like to sincerely apologise in public and take responsibility for my actions,” Maione quietly told the court through tears.
“I will bear this guilt for the rest of my life.”
She also apologised to others who rely on disability workers for causing "such distress."
Mr Ey told the court Maione was a "hard-working woman" who had cared for Ms Smith for up to six years and it was only in the last few months of her care that “the wheels fell off”.
“There is no doubt that the victim was a stubborn and difficult person,” he told the court.
“The victim was in fear of going into a home — was stubborn, demanding and the defendant… just didn't have the strength of character or personality to overcome what the victim demanded.”
Disability provider also guilty
Mr Ey told the court there was no excuse for the "grossly inadequate" care Maione provided but that her employer, Integrity Care, also had questions to answer.
“Integrity Care must have some answers to what occurred,” he told the court.
Justice Anne Bampton said she would find that “there is culpability resting at the door” of Integrity Care.
"I am going to conclude that Integrity Care are responsible for supervising their employee," she said.
"I should think the most basic thing would be for them to check on their employee in the environment they’ve been working in for six years to make sure that their employee is providing the care that they are receiving money for the Australian Government to provide.
"And therein the NDIS, what checks do they make, or have they made, or are they so run off they’re feet they’re not properly enquiring of those who are receiving money to care for people in the community?"
Ms Smith's death led to swift changes in the disability sector, although some argue there is much more work to be done.
Integrity Care fined, director charged
Maione's former employer, Integrity Care SA, was fined more than $12,000 by the NDIS Quality and Safeguards Commission for failing to report Ms Smith's death.
Police have also charged the former director of Integrity Care SA with assaulting and intimidating a key witness in the ongoing investigation into Ms Smith’s death.
Major Crime detectives have previously said $35,000 of jewellery and two fridges were missing from Ms Smith’s home.
They also revealed her car had been used by an unknown person, her inheritance had disappeared and that two separate loans totalling $70,000 were taken out in Ms Smith's name in the last six years.
Maione will be sentenced next week.
