Makoha Rest Home

Profile & contact details

Premises details
Premises nameMakoha Rest Home
Address 19 Ruihi Street Victoria Rotorua 3010
Total beds35
Service typesSensory, Medical, Physical, Geriatric, Intellectual, Rest home care
Certification/licence details
Certification/licence nameThe Rest Homes Limited
Current auditorHealthShare Limited
End date of current certificate/licence30 March 2018
Certification period36 months
Provider details
Provider nameThe Rest Homes Limited
Street address 19 Ruihi Street Victoria Rotorua 3010
Post address122 Pacific Drive Fitzherbert Palmerston North 4410

Progress on issues from the last audit

What’s on this page?

This rest home has been audited against the Health and Disability Services Standards. During the last audit, the auditors identified some areas for improvement.

Issues from their last audit are listed in the corrective actions table below, along with the action required to fix the issue, its risk level, and whether or not the issue has been reported as fixed.

A guide to the table is available below.

Details of corrective actions

Date of last audit: 22 June 2017

Outcome requiredFound at auditAction requiredRisk ratingAction statusDate action reported complete
Evaluations are documented, consumer-focused, indicate the degree of achievement or response to the support and/or intervention, and progress towards meeting the desired outcome.Two of the files reviewed do not include a six-monthly evaluation and review of the care plan. Ensure that an evaluation and updating of the care plan is completed six monthly. PA ModerateIn Progress
A system to identify, plan, facilitate, and record ongoing education for service providers to provide safe and effective services to consumers.Performance appraisals are not completed annually as per policy. Ensure that staff have a performance appraisal at least annually as per policy. PA ModerateIn Progress
Where progress is different from expected, the service responds by initiating changes to the service delivery plan.Not all care plans have been updated in response to changes in care. Ensure that care plans are updated as changes are identified. PA ModerateIn Progress
Key components of service delivery shall be explicitly linked to the quality management system.There is a lack of documented discussion of quality improvement that occurs as a result of discussion of data tabled. Document evidence of discussion of quality improvement. PA LowIn Progress
Activities are planned and provided/facilitated to develop and maintain strengths (skills, resources, and interests) that are meaningful to the consumer.Activities are not sufficiently reviewed for residents under the age of 65 years or for one to one activities for those who cannot or chose not to engage in group activities. Review the schedule/plan of activities for residents under the age of 65 years and/or one to one activities for those who cannot or chose not to engage in group activities. PA ModerateIn Progress

Guide to table

Outcome required

The outcome required by the Health and Disability Services Standards.

Found at audit

The issue that was found when the rest home was audited.

Action required

The action necessary to fix the issue, as decided by the auditor.

Risk level

Whether the required outcome was partially attained (PA) or unattained (UA), and what the risk level of the issue is.

The outcome is partially attained when:

  • there is evidence that the rest home has the appropriate process in place, but not the required documentation
  • when the rest home has the required documentation, but is unable to show that the process is being implemented.

The outcome is unattained when the rest home cannot show that they have the needed processes, systems or structures in place.

The risk level is determined by two things: how likely the issue is to happen and how serious the consequences of it happening would be.

The risk levels are:

  • negligible – this issue requires no additional action or planning.
  • low – this issue requires a negotiated plan in order to fix the issue within a specified and agreed time frame, such as one year.
  • moderate – this issue requires a negotiated plan in order to fix the issue within a specific and agreed time frame, such as six months.
  • high – this issue requires a negotiated plan in order to fix the issue within one month or as agreed between the service and auditor.
  • critical – This issue requires immediate corrective action in order to fix the identified issue including documentation and sign off by the auditor within 24 hours to ensure consumer safety.

The risk level may be downgraded once the rest home reports the issue is fixed.

Action status

Whether the necessary action is still in progress or if it is complete, as reported by the rest home to the relevant district health board.

Date action reported complete

The date that the district health board was told the issue was fixed.

Audit reports

Before you begin
Before you download the audit reports, please read our guide to rest home certification and audits which gives an overview of the auditing process and explains what the audit reports mean.

What’s on this page?

Audit reports for this rest home’s latest audits can be downloaded below.

Full audit reports are provided for audits processed and approved after 29 August 2013.  Note that the format for the full audit reports was streamlined from 16 December 2014.  Full audit reports between 29 August 2013 and 16 December 2014 are therefore in a different format. 

Prior to 29 August 2013, only audit summaries are available.

Both the recent full audit reports and previous audit summaries include:

  • an overview of the rest home’s performance, and
  • coloured indicators showing how well the rest home performed against the different aspects of the Health and Disability Services Standards.

Note: From November 2013, as rest homes are audited, any issues from their latest audit (the corrective actions required by the auditor) will appear on the rest home’s page. As the rest home completes the required actions, the status on the web site will update.

Audit reports

Audit date: 22 June 2017

Audit type:Surveillance Audit

Audit date: 08 August 2016

Audit type:Surveillance Audit

Audit date: 20 January 2015

Audit type:Certification Audit

Audit date: 24 March 2014

Audit type:Surveillance Audit

Audit date: 30 January 2013

Audit type:Certification Audit

Audit date: 09 March 2012

Audit type:Provisional Audit

Back to top