Following an investigation into the care provided to a 90 year old woman admitted to a hospital facility for respite care, the Deputy Health and Disability Commissioner has found that despite the woman regularly refusing food and fluids, or only consuming small amounts, no steps were taken to monitor this or to accurately assess her for dehydration. While it was accepted that the facility was under pressure managing a Norovirus outbreak during part of the admission, the Deputy Commissioner concluded that "the poor policies at [the facility] contributed to the poor care provided to [the woman]", noting that the staff were only required to document in the progress notes "once in 24 hours", and that the Nutritional Guidelines were unclear as to who was responsible for commencing a Fluid Intake Chart and only allowed the chart to be completed by the Registered Nurse Team Leader and clinical manager: "this may have resulted in an attitude among other staff that the responsibility for initiating such a chart also lay with the RNTL and clinical manager". The Deputy Commissioner found that the facility had breached Right 4(1) of the Code as it "failed to ensure [the woman] was provided with services with reasonable care and skill". 09HDC02159.