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City of Jyväskylä and service provider rebuked by Ombudsman

Elderly person in home care was left for days in a helpless condition
 
Ombudsman Petri Jääskeläinen has issued a reprimand to the City of Jyväskylä's social affairs and health department and to Harmonia Oy, a company which supplies home help and home medical care services to the City. In his view, shortcomings in the care provided, flows of information and documentation have endangered the lives and health of old people.

In the Ombudsman's assessment, the services with which Harmonia Oy provides the patient are not implemented appropriately, to a high standard or commensurate with the patient's needs. The City of Jyväskylä, in turn, did not give an aged person sufficient guidance in relation to a service procured using service vouchers, and the City did not have a clear method of action to ensure the quality of services produced by providers on the basis of service vouchers.

Safety phone alarm not responded to

An elderly person had been in Kyllö Hospital for rehabilitation after an operation and had then been transferred to home care. Already the following day, a practical nurse working for Harmonia had found that the patient could not cope at home and it was agreed that he would return to the hospital. 

This was the beginning of a chain of events in which practical nurses changed, information was not passed on and ended in the patient being discovered lying helpless on the floor by the fifth practical nurse and a medical nurse, four days after he had been sent home. The elderly patient had sent an alarm from his safety phone a couple of days earlier, but it had not been responded to. An ambulance had been requested, but the elderly patient was taken to the on-call health centre in an invalid taxi without anyone to accompany him.

A doctor at the on-duty health centre concluded that the patient had been brought there by mistake and sent him to the hospital. From there he was returned to the health centre and on to the Central Hospital for further examination and treatment.

An examination at the central hospital revealed that the patient was dehydrated and had suffered muscle damage from lying on the floor. He received rehydration treatment for three days and was transferred to Kyllö Hospital for further treatment.

Bad organisation

The Ombudsman blames poor organisation of functions for the failure of home care for the elderly.

He finds that Harmonia acted inappropriately when the patient was not taken for the necessary treatment, but was instead left home alone and without services, and when an alarm from his safety phone was not responded to and his situation was not looked into. When the patient was finally taken for treatment, the nurse did not go along to escort him, and it was not ensured that background data were sent to the unit providing the treatment.

The Ombudsman is of the view that Harmonia must evaluate the risks of its activities and draft procedural guidelines to prevent danger situations and improve client safety.

Jyväskylä did not oversee the quality of services

The Ombudsman has criticised the City of Jyväskylä for the fact that the patient was not sufficiently familiarised with the services that can be obtained from Harmonia with service vouchers.
 
- The City must pay attention to the client's freedom of choice and individual needs when assessing how the social welfare and health services that he or she needs are to be arranged, he points out.

Something that he considers a shortcoming is that the City of Jyväskylä did not have a clear way of acting to ensure that the services provided by suppliers against vouchers were of a high quality. These services must correspond to at least the standard that can be demanded of municipal services. 

- A municipality's responsibility to monitor is accentuated, because a service provider is performing a public task when social welfare and health care services are provided by means of service vouchers, the Ombudsman points out. 

Kyllö Hospital was rebuked by the Ombudsman for the failings in communications between the health centre and the hospital, as a result of which examination and treatment of the elderly patient were delayed by one day.


Additional info will be provided by Senior Legal Adviser Kaija Tanttinen-Laakkonen, tel. +358(0) 94323377.