HDC Code of Rights NZ – Aged Care Compliance Guide
The Health and Disability Commissioner (HDC) Code of Rights (the Code) is the cornerstone of consumer protection in New Zealand’s health and disability sector. For aged care providers, compliance is not optional — it is a legal requirement under the Health and Disability Commissioner Act 1994 (the Act). This guide covers all 10 rights, aged care obligations, how HDC complaints work, and notification duties. It is written for frontline managers who need practical, actionable compliance advice.
What is the HDC Code of Rights?
The Code of Health and Disability Services Consumers’ Rights (the Code) came into effect on 1 July 1996. It sets out the rights of every person receiving health or disability services in New Zealand, including residents of aged care facilities. The Code is enforced by the Health and Disability Commissioner (HDC). Breaches can lead to formal complaints, investigations, and adverse findings.
Key point: The Code applies to all aged care services — rest homes, dementia units, hospital-level care, and home support. It covers both public and private providers.
The 10 Rights Under the Code
Each right is set out in Regulation 2 of the Health and Disability Commissioner (Code of Health and Disability Services Consumers’ Rights) Regulations 1996 (SR 1996/78). Below is a summary with aged care examples.
Right 1 – Right to be Treated with Respect
Consumers have the right to be treated with respect, including respect for their dignity, independence, privacy, and cultural values. In aged care, this means addressing residents by their preferred name, knocking before entering rooms, and respecting cultural practices (e.g., tikanga Māori, religious observances).
Right 2 – Right to Freedom from Discrimination, Coercion, Harassment, and Exploitation
This right aligns with the Human Rights Act 1993. Aged care providers must not discriminate on grounds such as age, disability, race, or sexual orientation. Coercion (e.g., forcing a resident to eat) or exploitation (e.g., misuse of a resident’s funds) is prohibited.
Right 3 – Right to Dignity and Independence
Consumers have the right to services that support their dignity and independence. For example, enabling a resident to choose when to get up, what to wear, and how to spend their day. Restraint or seclusion must be minimised and justified.
Right 4 – Right to Services of an Appropriate Standard
Services must be provided with reasonable care and skill, in line with professional standards. This includes adequate staffing, safe premises, and proper infection control. The Health and Disability Services (Safety) Act 2001 and the NZS 8134:2021 Health and Disability Services Standards set the benchmark.
Right 5 – Right to Effective Communication
Consumers have the right to information in a format they understand. For residents with hearing loss, dementia, or limited English, providers must use interpreters, visual aids, or plain language. This includes care plans and consent forms.
Right 6 – Right to be Fully Informed
Before any treatment or care, residents must receive full information about their condition, options, risks, and costs. This includes the right to ask questions and receive honest answers. For example, a resident must be told about the side effects of a new medication.
Right 7 – Right to Make an Informed Choice and Give Informed Consent
This is one of the most critical rights in aged care. Consumers have the right to choose whether to accept or refuse care. This includes the right to refuse treatment (Right 7(7)). Consent must be voluntary, informed, and ongoing. For residents lacking capacity, the Protection of Personal and Property Rights Act 1988 (PPPR Act) governs substitute decision-making.
Key point – Right 7(7): Every consumer has the right to refuse services, even if that refusal may result in harm or death. Aged care providers must respect this, document the refusal, and manage risks (e.g., through a care plan review).
Right 8 – Right to be Provided with Support
Consumers have the right to have a support person of their choice present, unless it would unreasonably interfere with others. In aged care, this often means family members or advocates being present during care discussions or procedures.
Right 9 – Rights in Respect of Teaching or Research
Residents must not be used for teaching or research without their informed consent. This applies to student placements or clinical trials in aged care facilities.
Right 10 – Right to Complain
Consumers have the right to complain about any breach of the Code. Complaints can be made to the provider directly, to the HDC, or to the Health and Disability Advocacy Service. Providers must have a complaints process, respond promptly, and not retaliate against complainants.
Aged Care Obligations Under the Code
Frontline managers must ensure their facility meets these obligations:
- Policies and procedures: Document how each right is upheld (e.g., consent policy, complaints policy).
- Staff training: All staff must understand the Code and how to apply it daily. Annual refresher training is recommended.
- Consent processes: Use the Health and Disability Commissioner (Code of Health and Disability Services Consumers’ Rights) Regulations 1996 as the basis for consent forms. For residents who lack capacity, follow the PPPR Act and involve the resident’s welfare guardian or enduring power of attorney.
- Complaints management: Have a written complaints procedure that meets the requirements of Right 10. Respond within 5 working days (HDC guideline).
- Notification: If a resident suffers a serious adverse event (e.g., fall with fracture, medication error causing harm), notify the HDC under section 31 of the Act. Also notify the Ministry of Health under the Health and Disability Services (Safety) Act 2001.
How HDC Complaints Work
The HDC complaint process is set out in Part 4 of the Act. Here is the typical flow:
- Complaint received: A resident, family member, or advocate lodges a complaint with the HDC (online, phone, or post).
- Assessment: The HDC assesses whether the complaint falls within its jurisdiction and whether it raises a potential breach of the Code.
- Resolution: Many complaints are referred to the Health and Disability Advocacy Service for informal resolution. This is free and confidential.
- Investigation: If the complaint is serious or cannot be resolved, the HDC may investigate. The provider will be asked to provide a written response and relevant records.
- Outcome: The HDC may find no breach, a breach, or refer the matter to the Director of Proceedings for possible legal action (e.g., before the Human Rights Review Tribunal).
- Notification: The HDC will notify the provider, the complainant, and any relevant professional bodies (e.g., Nursing Council) of the outcome.
Key point: The HDC can order a provider to apologise, change policies, or pay compensation (up to $200,000 in some cases). Serious breaches may result in public naming.
Notification Duties
Under section 31 of the Act, providers must notify the HDC of any serious adverse event. This includes:
- Unanticipated death or serious injury.
- Serious harm from treatment or care.
- Events that require immediate intervention to prevent further harm.
Notification must be made as soon as possible, and a written report must follow within 10 working days. Failure to notify can itself be a breach of the Code.
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Practical Tips for Frontline Managers
- Display the Code: A copy of the Code must be prominently displayed in every facility (Regulation 3 of the Code).
- Use advocates: Encourage residents and families to use the Health and Disability Advocacy Service (0800 555 050) for free support.
- Document everything: Consent discussions, refusals, and complaints must be recorded in the resident’s clinical record.
- Review regularly: Conduct annual audits of compliance with the Code, using the HDC’s self-assessment tool.
- Train staff: Include the Code in induction and ongoing training. Use real-life scenarios (e.g., a resident refusing a shower).
Key Legislation and Standards
- Health and Disability Commissioner Act 1994 – establishes the HDC and the Code.
- Health and Disability Commissioner (Code of Health and Disability Services Consumers’ Rights) Regulations 1996 – the Code itself.
- Health and Disability Services (Safety) Act 2001 – sets standards for aged care facilities.
- Protection of Personal and Property Rights Act 1988 – governs consent for residents lacking capacity.
- Human Rights Act 1993 – underpins Right 2.
- NZS 8134:2021 Health and Disability Services Standards – operational standards for aged care.
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Frequently asked questions
What is the HDC Code of Rights NZ?
The Code of Health and Disability Services Consumers’ Rights (the Code) is a set of 10 rights that every person receiving health or disability services in New Zealand is entitled to. It is enforced by the Health and Disability Commissioner (HDC) and is legally binding under the Health and Disability Commissioner Act 1994.
How does Right 7 apply in aged care?
Right 7 gives residents the right to make an informed choice and give informed consent. Right 7(7) specifically allows a resident to refuse treatment or care, even if that refusal may lead to harm or death. Aged care providers must respect the refusal, document it, and manage risks through a care plan review.
What is the HDC complaint process for aged care?
A complaint can be made to the provider, the HDC, or the Health and Disability Advocacy Service. The HDC assesses the complaint, may refer it for informal resolution, or investigate. Outcomes can include a finding of breach, an apology, policy changes, or referral to the Director of Proceedings for legal action.
What are the notification requirements under the HDC Code?
Under section 31 of the Health and Disability Commissioner Act 1994, providers must notify the HDC of any serious adverse event, such as unanticipated death, serious injury, or harm requiring immediate intervention. Notification must be immediate, with a written report within 10 working days.
What are the aged care obligations under the Code?
Aged care providers must have policies and procedures for each right, train staff on the Code, obtain informed consent (following the PPPR Act for residents lacking capacity), manage complaints promptly, and notify the HDC of serious adverse events. The Code must also be displayed in every facility.