Over 100 Audit Reports of NZ Resthomes reviewed.

How do the rest homes / aged care facilities stack up when it comes to Ministry of Health audits? In July 2014, Consumer reviewed 123 of these audit reports. Of the 123 facilities for which 'audits' were available, less than 12% met all the criteria that they were assessed against.

Consumer went on to report that at one specific facility, "Among the shortfalls, the audit found there had been at least four occasions when residents left the home unwitnessed by staff and without staff knowledge. These events are required to be reported to the Ministry of Health. However, the ministry wasn’t notified on any occasion."  The article continued, saying "During the previous audit, residents had been observed exhibiting “challenging behaviour ... rattling the front door trying to leave the premises, rattling the door to the enclosed walking area, and swearing at each other”. The auditors found no evidence staff had been trained in dealing with this type of behaviour.

Despite the home being required to remedy shortfalls, problems were still evident seven months later. The report resulting from the January audit found:

• Timeframes for initial care plans and GP assessments weren’t consistently adhered to and resident documentation wasn’t always complete.
• Controlled drugs weren’t checked weekly and a discrepancy in prescribing an antibiotic wasn’t discovered for five days.
• The menu plan wasn’t being followed and food was left on a trolley for over three hours before it was served.
• Four out of five staff files didn’t have evidence to show references had been checked.
• Infection-control data wasn’t always recorded and evaluated. The home had a norovirus outbreak in March 2013 and a suspected scabies outbreak during April and May 2013."

So how do these audits work? On the Ministry of Health Website (www.health.govt.nz) you can find an explanation as to how the system works. In summary, certification audits happen every 1–4 years. After the audit, aged care facilities are certified for a set period of time (the exact length depends on how well the rest home performed at the certification audit). Once this time is up, the rest home must be re-audited and its certification renewed.

An unannounced spot audit (also called a surveillance audit) happens around the middle of a rest home’s certification period. The spot audit ensures progress has been made on outstanding areas identified in the earlier certification audit and that standards haven’t slipped.

In addition to audits, rest homes have to report to their DHB on how they are addressing issues found at audit. These improvements are then verified at the next audit event. 

The Ministry's website states that audit teams look at:

• staff
• the way residents are cared for
• how the staff interact with residents
• the general environment
• clinical records, policies and procedures.

It also says they interview staff, residents and family members.

AgedAdvisor agrees that these audits are necessary. They provide 'checks and balances' to the processes and systems implemented within the aged care facilities and ensure that correct methods and protocols are followed for such things as administering medicine, handling patients, hygiene standards, internal reporting policies etc.

However, we see other areas that the audits try to cover but fail to properly identify. It's only from living or visiting these facilities - on a regular basis, that you experience the reality of what that facility is really like, which is why AgedAdvisor was created - to help share yours, and our experiences, so that we know what to expect before making that next step.

For the full consumer report, visit https://www.consumer.org.nz/articles/rest-homes