Two of three mental health facilities inspected without warning by the Chief Ombudsman last year have been deemed not fit for purpose.
Chief Ombudsman Peter Boshier detailed his findings in three separate reports released today.
Unannounced inspections were carried out last year on Middlemore's Tiaho Mai unit, Palmerston North Hospital's STAR 1 unit, and Hutt Hospital's Te Whare Ahuru unit.
The acute care mental health inpatient facilities were inspected under the Crimes of Torture Act.
Boshier found the building housing Hutt Hospital's Te Whare Ahuru was not fit for purpose and described standards of both cleanliness and maintenance as inadequate.
"I have made an amended repeat recommendation that the building is upgraded as a matter of urgency, and that cleanliness and facilities maintenance issues are attended to as a matter of priority."
Boshier said there had also been "potentially degrading treatment" at the Hutt Hospital unit.
"There were some concerning findings in the report, such as an incident in which a service-user could not access a bathroom and had an undignified incident as a result," he said.
"I am also disappointed about the ongoing use of non-designated rooms, including seclusion rooms, as bedrooms when the unit is over occupancy. I consider this completely inappropriate. In no other area of a hospital would you expect to see people sleeping in such environments, and nor do I expect to see service users in mental health facilities treated this way."
Boshier had recommended over-occupancy be addressed as a matter of urgency and that non-designated rooms should never be used as bedrooms.
Hutt Valley District Health Board had accepted 12 of the 18 total recommendations made by him, partially accepted five and rejected one.
In another report, Boshier found Palmerston North Hospital's psychogeriatric unit, STAR 1, was not fit for purpose either.
He said the unit has an institutional feel, lacks space for group activities, has no dining room or kitchen for patients, no quiet communal areas, an unsafe outdoor area with restricted access, and a small, poorly resourced patient lounge.
Boshier "concerningly" found the use of restraint had increased since STAR 1 was moved to a new location in June last year.
"My report makes two amended repeat recommendation to STAR 1 about the environment not being fit for purpose and not conducive to improving the wellbeing of the service users," he said.
"The environment was a reason given for the increased use of restraint in the unit. If not addressed, this may affect treatment and conditions."
MidCentral District Health Board had accepted four of the five recommendations made and partially accepted the other.
Meanwhile, Middlemore Hospital's Tiaho Mai unit was praised as showing the positive impact a purpose-built, fit for purpose facility environment could have.
"I was pleased to find that the new facilities were light, modern, therapeutic and considered in their design," Boshier said.
"In my opinion it is a model for recovery and service user-centred care and the thoughtful design of the admission suite, in particular, is commendable."
However, Boshier also said aspects of the unit's administration needed addressing. This included incomplete collation and reporting of seclusion and restraint data.
Voluntary service users also had no information about the process for coming and going from the unit, as they are entitled to, Boshier said.
He made 15 recommendations to the Counties Manukau District Health Board as a result.
Three of them were repeat recommendations from an inspection carried out in 2015, with the DHB accepting all but one.
"Units such as these provide care for some of our most vulnerable and unwell people. It is crucial that they meet the standards of care and therapy we as a society expect," Boshier said.