3

H.—26

female side he is assisted by two nurses. .None of the stall have received any training as nurses, with the exception of one of the female attendants who has been for nine years an asyium-attendaut. There are very few inmates who are able to assist either on the male or female side. A medical man visits the institution three times a week, and at other times if urgently required. There are three beds in the maternity ward, one of which was occupied at the date of our inspection. The class of persons we found in the Home were principally old people, most of whom were suffering from the diseases incidental to old age. Many of tiiem were bedridden, paralysed, epileptic, blind, or imbecile, requiring constant attention, which it was impossible they could receive owing to the limited and incompetent staff of the institution, und its imperfect appliances. Wβ found in the Home five persons who, in our opinion, and in the opinion of the medical man in charge, were mentally deranged and unfit to be in the institution. The necessary steps were taken during our visit, at the instance of the medical officer, to have these persons examined, with a view to their being sent to the lunatic asylum. We also found a young man suffering with phthisis who is since dead. There is also a boy in the Home, who was sent in from the hospital, whose thigh had been recently amputated. The number of inmates at present in the Home is 196, of whom 151 are males and 45 females. Sixty-one of the inmates receive old-age pensions, 7 receive old-age and Imperial pensions, 2 receive Imperial pensions only, while 18 inmates are paid for by their friends at the rate of from £1 to 3s. per week (see return attached). The institution receives the moneys so paid to pensioners, and allows them Is. each per week for pocket-money. We found that the staff of the Home has always been insufficient. When the services of Mr. and Mrs. Moss, the former Manager and Matron, were dispensed with, the staff was as follows: The Manager, assisted by his wife and one female nurse, two male attendants, a housemaid, and one cook, the number of inmates at that date being 173. The laundry staff always was and is employed exclusively in laundry work. The garden and ground are under the care of a gardener and an assistant, those of the old men who are able to do a little work finding light employment under his directions. Vegetables for the use of the Auckland Hospital and the Home are produced in the garden. About fifteen old men are employed in assisting the six paid laundresses. Excluding the present staff, there is abundant evidence of drunkenness in the institution extending over many years, both as regards some members of the staff and the inmates. Some members of the staff who had been repeatedly reported for drunkenness were, notwithstanding such reports by the then Manager Mr. Moss, retained in the service of the Board, in some instances with the consent of the Manager. This is subversive of all discipline. With the above exceptions, the Board and the Managers of the Home appear to have done their best to suppress drunkenness. It is unfortunate in this connection that there is a licensed house within a quarter of a mile of the institution. We inquired inter alia into the complaints by John and Eliza Moss as to their dismissal from their positions as Manager and Matron of the Home. While we are of opinion that the Board was fully justified in dispensing with their services after giving them an opportunity of resigning, which they declined to do, we feel that Mr. Moss, as Manager, had for many years carried on his duties under great difficulties. One of the reasons why the Board dispensed with his services was on account of the dirty condition of the Home. We are of opinion it was absolutely impossible to keep it clean with the staff at Mr. Moss's disposal. He repeatedly drew the attention of the Board to the fact that the stafi was insufficient, without receiving any substantial addition to it. It appears to us that the Board were far more responsible for the dirty and comfortless condition of the Home than were Mr. and Mrs. Moss. With reference to the charge against Mr. Moss that he was harsh to certain inmates, we are satisfied —1. That he placed a woman in the refractory-ward in the ordinary course of his duty and omitted to report it. This was a neglect of duty. 2. That another woman was harshly treated by being kept for thirteen days in the refractory-ward when she was known to be an epileptic. It was perfectly clear to us that the relations of Mr. Moss with the Board had become so strained in many ways that it was imperative a change should be made. As regards the present staff of the Home we consider it insufficient. We are of opinion that, as most of the inmates are aged invalids, fewer male attendants and more trained female nurses should be employed. It frequently happens that intractable male persons are admitted to the Home, but we think that the Manager, assisted by one male attendant, should be able to deal with such cases. All other classes of inmates, whether well or sick, would be better looked after by women. Take, for instance, the jnfirmary wards, male and female, which are filled with aged sick persons requiring careful and constant attention which can only be given to them by hospital trained female nurses. At present there is no night nurse in the female infirmary ward, and a night watchman varies the charge of the male infirmary ward with a general oversight of the whole institution. The result must be that the patients are neglected except for the care that one sick person can give to another. We recommend the following staff: (1) A Manager ; (2) a Matron, who should be a trained nurse; (3) one male attendant; (4) three trained female nurses on the male side; (5) three trained female nurses on the female side —one of these nurses to act as a night nurse in the male infirmary ward, and one in the female infirmary ward. These nurses should not be less than thirty years ago. This is irrespective of any cooking staff that may be necessary. We recommend that the old bedsteads be replaced by new ones of hospital pattern, that all straw mattresses and pillows should be abolished, and that mackintosh sheets should be used where required. The bedding should be thoroughly overhauled, a great number of the blankets being worn threadbare. Lockers or cupboards of a uniform pattern should be provided for each inmate, and