Warning: This story contains content that will be distressing to some readers.
It was one of the most shocking cases of manslaughter by criminal neglect that had ever occurred in South Australia. Adelaide disability support worker Rosa Maria Maione has now been jailed for over six years for the neglect that led to the death of NDIS client Ann Marie Smith.
Ms Smith had been living a reserved, solitary life prior to becoming the victim of Ms Maione’s, now officially ruled, ‘gross criminal neglect’.
The ABC reported Justice Anne Bampton noted during sentencing that Ms Smith’s death was preventable.
“It is clear the care of Ann Smith was compromised from the time you became her sole support worker,” Justice Bampton noted.
“Whilst Ms Smith’s autonomous position has to be respected, she required the involvement of her service provider Integrity Care and health providers.
“You had absolutely no insight into Ms Smith’s physical condition leading up to her death – your incompetence, lack of training, lack of assertiveness … produced an environment where you failed to provide appropriate care.”
“The tragedy is that if you had acknowledged your limitations and sought professional assistance … and if you and Integrity Care had provided that support in a safe and competent manner with skill and care, her death could have been prevented.”
Ms Smith had been taken care of by her mother, until her death a few years prior to her daughter’s.
Speaking before the Supreme Court, Ms Smith’s brother Glenn Smith described how he had become estranged after vocalising his worries surrounding “how her support workers were taking advantage of her”.
The Supreme Court heard Ms Smith originally had “no issues with decision making”. However, her mobility significantly became so reduced that she was “essentially bed ridden” and was then living and sleeping in a cane chair.
The court heard how the 54-year-old became “totally dependent” on Ms Maione. Working within the overarching National Disability Insurance Scheme (NDIS), the disability support worker was contracted to complete six hours of care for Ms Smith daily, every day of the week, with an additional two hours for shopping and cleaning.
These hours were grossly under the amount needed, the prosecution argued. Ms Smith would have needed two carers daily to assist with her basic routine and care – to complete all the required washing, toileting, preparation of food, feeding and dressing.
It came to light that Ms Maione would never have been able to lift Ms Smith alone, and a gardener was called on to assist in two separate occasions.
Going into the contract, Ms Maione would have known her limitations as she had sustained an injury to her shoulder in 2014, rendering her incapable of proceeding to work with high needs clients.
During sentencing submission, the prosecution through prosecutor Lucy Boord SC, argued Ms Maione would clearly have understood she was “incapable” of providing the care Ms Smith needed, yet she never voiced her need for help.
It was uncovered that Ms Smith, during her time of being cared for by Ms Maione, lived, slept and went to the toilet in a cane chair that investigators found to have been soiled so severely it was beginning to decompose.
Prosecutor Boord previously addressed the court and stated, “The question has to be asked, what did she do for all of that time at Ann Marie Smith’s house?”
Continuing, “She didn’t seek assistance … from either her supervisors or medical professionals before it was too late.
“The neglect of Ann Marie Smith was not simply the act of not moving her from that cane chair, the neglect of Ann Marie Smith was absolute; she was not properly fed, she was not properly bathed, she was not properly toileted, her teeth had not been cleaned.”
Ms Maione’s first initiative for help was to call for an ambulance for Ms Smith in April 2020. At that point the NDIS patient had developed a sore that was 15 centimetres deep and so gangrenous that her hip bone could be seen.
Ms Smith died soon after from multiple organ failure linked to the untreated pressure sore on her side.
A treating doctor described to the court that it was one of the most severe pressure wounds he had ever seen across his professional career.
Medical personnel also testified to further evidence of neglect. Ms Smith ws significantly dehydrated and malnourished, her skin had severely broken down on the left side of her body.
For months Ms Smith’s toenails had not been cut, additionally she was found to have no bottom teeth remaining and was suffering from pronounced gum disease.
Prosecutor Lucy Boord SC had previously addressed the court regarding Ms Maione’s “gross neglect” spanning multiple months, however, she stated she would be unable to provide the precise moment when it commenced.
Ms Maione brought her apology before court regarding her crime. She accepted her actions to have “caused so much distress in the disability community and people who rely on carers”.
The sentenced, Rosa Maria Maione, 70, may be granted parole in little over five years, however, it is likely she will then be deported to Italy when released from prison. Some have commented she is set to be an “elderly woman” and “alone is a foreign country”.
Stephen Ey, acting on behalf of Ms Maione, argued that Ann Marie Smith could at times be a difficult and stubborn person to manage, often refusing Ms Maione’s efforts to provide medical assistance due to not wishing to be placed in a nursing facility.
Ms Boord argued Ms Maione was attempting to distance herself from the full degree of responsibility with the range of explanations heard in the trial, listing them as “complete apathy to victim-blaming to blaming Integrity Care”.
“This was the defendant’s job … she was paid to take care of Ann Marie Smith and she didn’t,” she previously conveyed to the court.