Part 4: Person-centred and safe environment

Section 4.1: The facility

Criterion 4.1.1

Guidance for all providers

Ensure the facility has considered the use of the environment for various activities and cultural needs. For example, creating/improving culturally appropriate environments for whānau visiting and supporting Māori in your service. These environments could take the form of a separate space for whānau to gather, such as whānau rooms in hospitals. This ensures safe, and culturally appropriate spaces to have gathering, share kai, have karakia and other practices that centre around a holistic approach to care. Further, a pre-emptive approach to identifying those that would benefit from such spaces and proactively offering access, as opposed to whānau needing to ask, could promote wellbeing and help minimise disincentives such as feeling like a burden.

Criterion 4.1.2

Aged care: Guidance

• External areas are independently accessible.
• Service providers consider: 
  1. minimising environmental hazards
  2. using amenities, fixtures, equipment, and furniture that meet infection prevention requirements, and are easy to clean and maintain
  3. providing non-slip surfaces or other safe, effective means of minimising slipping in areas frequently exposed to moisture or slippery substances.
• The external environment of the home shows that the service provider:
  1. maintains and trims gardens and trees, and manages allergy-producing plants to meet the needs of the people receiving services
  2. considers sensory stimulation and aids – for example, chimes, use of colour contrast for low vision and fragrance gardening – to help people to negotiate their external environment
  3. makes outside spaces accessible for all the people in the house, including through ground surface indicators and non-slip surfaces.
• Service providers provide shade in the outside space.
• The physical environment supports the independence of people receiving services, such as through appropriately placed handrails.
• When people need to be transported or transferred between rooms or services in beds or wheelchairs, doorways, thoroughfares, lifts, and turning areas can readily accommodate the bed or wheelchair, attached equipment, and any escorts.

Fertility services: Guidance

• Service providers consider:
  1. minimising environmental hazards
  2. using amenities, fixtures, equipment, and furniture that meet infection prevention requirements, and are easy to clean and maintain
  3. providing non-slip surfaces or other safe, effective means of minimising slipping in areas frequently exposed to moisture or slippery substances.

Residential disability: Guidance

• External areas are independently accessible.
• Service providers consider:
  1. minimising environmental hazards
  2. using amenities, fixtures, equipment, and furniture that meet infection prevention requirements, and are easy to clean and maintain
  3. providing non-slip surfaces or other safe, effective means of minimising slipping in areas frequently exposed to moisture or slippery substances.
• The external environment of the home shows that the service provider:
  1. maintains and trims gardens and trees, and manages allergy-producing plants to meet the needs of the people receiving services
  2. considers sensory stimulation and aids – for example, chimes, use of colour contrast for low vision and fragrance gardening – to help people to negotiate their external environment
  3. makes outside spaces accessible for all the people in the house, including through ground surface indicators and non-slip surfaces.
• Service providers provide shade in the outside space.
• The internal environment of the home shows:
  1. the service provider’s office equipment is not in the living space unless the space can be used by everyone in the house
  2. it has adequate task and general lighting, dimmer switches for low vision, handrails, and other supporting features as required.
• The home has safety locks on windows to allow safety as well as security.

Residential mental health and alcohol and other drug: Guidance

• Service providers consider: 
  1. minimising environmental hazards
  2. using amenities, fixtures, equipment, and furniture that meet infection prevention requirements, and are easy to clean and maintain
  3. providing non-slip surfaces or other safe, effective means of minimising slipping in areas frequently exposed to moisture or slippery substances.
• The external environment of the home shows that the service provider:
  1. maintains and trims gardens and trees, and manages allergy-producing plants to meet the needs of the people receiving services
  2. considers sensory stimulation and aids – for example, chimes, use of colour contrast for low vision and fragrance gardening – to help people to negotiate their external environment
  3. makes outside spaces accessible for all the people in the house, including through ground surface indicators and non-slip surfaces.
• Service providers provide shade in the outside space.

Public/private hospital: Guidance

• When designing (or redesigning) services, service providers consider:
  1. the impact of the facility design on service delivery models
  2. versatile, flexible spaces (for example, open design to allow open space such as ‘marae’ style)
  3. accommodation that meets particular cultural or identity needs of people
  4. a co-design approach.
• Service providers consider:
  1. minimising environmental hazards
  2. using amenities, fixtures, equipment, and furniture that meet infection prevention requirements, and are easy to clean and maintain
  3. providing non-slip surfaces or other safe, effective means of minimising slipping in areas frequently exposed to moisture or slippery substances.

Birthing units: Guidance

• When designing (or redesigning) services, service providers consider:
  1. the impact of the facility design on service delivery models
  2. versatile, flexible spaces (for example, open design to allow open space such as ‘marae’ style)
  3. accommodation that meets particular cultural or identity needs of people
  4. a co-design approach.
• Service providers consider:
  1. minimising environmental hazards
  2. using amenities, fixtures, equipment, and furniture that meet infection prevention requirements, and are easy to clean and maintain
  3. providing non-slip surfaces or other safe, effective means of minimising slipping in areas frequently exposed to moisture or slippery substances.

Hospice: Guidance

• When designing (or redesigning) services, service providers consider:
  1. the impact of the facility design on service delivery models
  2. versatile, flexible spaces (for example, open design to allow open space such as ‘marae’ style)
  3. accommodation that meets particular cultural or identity needs of people
  4. a co-design approach.
• Service providers consider:
  1. minimising environmental hazards
  2. using amenities, fixtures, equipment, and furniture that meet infection prevention requirements, and are easy to clean and maintain
  3. providing non-slip surfaces or other safe, effective means of minimising slipping in areas frequently exposed to moisture or slippery substances.

Abortion services: Guidance

• Service providers consider:
  1. minimising environmental hazards
  2. using amenities, fixtures, equipment, and furniture that meet infection prevention requirements, and are easy to clean and maintain
  3. providing non-slip surfaces or other safe, effective means of minimising slipping in areas frequently exposed to moisture or slippery substances.

Criterion 4.1.3

Aged care: Guidance

• The home has adequate space for equipment, individual, and group activities, and quiet space for people receiving services and their whānau.
• Service providers consider relevant resources when renovating, including Lifemark standards and Homestar standards.
• Where services provide dementia and psychogeriatric services, they consider relevant resources when renovating – for example. Lifemark standards, Homestar standards, and the Ministry of Health’s (2016) Secure Dementia Care Home Design: Information resource.

Residential disability: Guidance

• The people in the household have the ultimate authority about how spaces are used and set up.
• Service providers provide visual prompts and cues in homes as needed to enhance communication.
• Houses have adequate room for the people who live in them.

Criterion 4.1.4

Aged care: Guidance

• Gender-neutral toilets are available in shared spaces.
• Toilets are of a suitable size to accommodate equipment and the activity required for the person receiving services.
• Processes are in place to assure privacy.
• When designing services for people with dementia or psychogeriatric needs, service providers consider available resources; for example, Ministry of Health (2016) Secure Dementia Care Home Design: Information resource.

Fertility services: Guidance

• Gender-neutral toilets are available in shared spaces.
• Toilets are of a suitable size to accommodate equipment and the activity required for the person receiving services.
• Processes are in place to assure privacy.

Residential disability: Guidance

• Gender-neutral toilets are available in shared spaces.
• Toilets are of a suitable size to accommodate equipment and the activity required for the person receiving services.
• Processes are in place to assure privacy.
• No toilet doors have signs stating, ‘staff toilet only’.
• Showers are accessible to all people.

Residential mental health and alcohol and other drug: Guidance

• Gender-neutral toilets are available in shared spaces.
• Toilets are of a suitable size to accommodate equipment and the activity required for the person receiving services.
• Processes are in place to assure privacy.
• No toilet doors have signs stating, ‘staff toilet only’.
• Showers are accessible to all people.

Public/private hospital: Guidance

• Gender-neutral toilets are available in shared spaces.
• Toilets are of a suitable size to accommodate equipment and the activity required for the person receiving services.
• Processes are in place to assure privacy.

Birthing units: Guidance

• Gender-neutral toilets are available in shared spaces.
• Toilets are of a suitable size to accommodate equipment and the activity required for the person receiving services.
• Processes are in place to assure privacy.

Hospice: Guidance

• Gender-neutral toilets are available in shared spaces.
• Toilets are of a suitable size to accommodate equipment and the activity required for the person receiving services.
• Processes are in place to assure privacy.

Abortion services: Guidance

• Gender-neutral toilets are available in shared spaces.
• Toilets are of a suitable size to accommodate equipment and the activity required for the person receiving services.
• Processes are in place to assure privacy.

Criterion 4.1.5

Aged care: Guidance

• People who use mobility aids are able to safely manoeuvre with their aid within their personal space/bed area.
• Where people need to be transported or transferred between rooms or services, doorways, thoroughfares, lifts, and turning areas can readily accommodate the bed, attached equipment, and any escorts.

Residential disability: Guidance

• People who use mobility aids are able to safely manoeuvre with their aid within their personal space/bed area.
• Where people need to be transported or transferred between rooms or services, doorways, thoroughfares, lifts, and turning areas can readily accommodate the bed, attached equipment, and any escorts.

Criterion 4.1.6

Aged care: Guidance

• The external window can be opened, allowing fresh air into the room, and is suitable to the environment of the person’s room. For example, the room may have an external ranch slider. 
• Service providers monitor the environmental temperature.
• Service providers have implemented processes to manage significant temperature changes. 

Residential disability: Guidance

• The external window can be opened, allowing fresh air into the room, and is suitable to the environment of the person’s room. For example, the room may have an external ranch slider. 
• Service providers monitor the environmental temperature.
• Service providers have implemented processes to manage significant temperature changes.
• Service providers supply effective heating for healthy and enjoyable lives. 

Criterion 4.1.7

Fertility services: Guidance

• Service providers consider the evidence around what makes Māori receiving services and their whānau feel culturally safe.
• Evidence shows service providers seek comprehensive feedback from Māori and their whānau.

Residential disability: Guidance

• Service providers consider the evidence around what makes Māori receiving services and their whānau feel culturally safe.
• Evidence shows service providers seek comprehensive feedback from Māori and their whānau.

Residential mental health and alcohol and other drug: Guidance

• Service providers consider the evidence around what makes Māori receiving services and their whānau feel culturally safe.
• Evidence shows service providers seek comprehensive feedback from Māori and their whānau.

Public/private hospital: Guidance

• Service providers consider the evidence around what makes Māori receiving services and their whānau feel culturally safe.
• Evidence shows service providers seek comprehensive feedback from Māori and their whānau.

Birthing units: Guidance

• Service providers consider the evidence around what makes Māori receiving services and their whānau feel culturally safe.
• Evidence shows service providers seek comprehensive feedback from Māori and their whānau.

Hospice: Guidance

• Service providers consider the evidence around what makes Māori receiving services and their whānau feel culturally safe.
• Evidence shows service providers seek comprehensive feedback from Māori and their whānau.

Abortion services: Guidance

• Service providers consider the evidence around what makes Māori receiving services and their whānau feel culturally safe.
• Evidence shows service providers seek comprehensive feedback from Māori and their whānau.

Section 4.2: Security of people and workforce

Criterion 4.2.1

Guidance for all providers

• Service providers meet the reporting requirements of the New Zealand Fire Service as specified in the Fire and Emergency New Zealand (Fire Safety, Evacuation Procedures, and Evacuation Schemes) Regulations 2018.

Criterion 4.2.2

Guidance for all providers

• Where applicable, service providers have an emergency management plan that links to local district health board and local authority (Civil Defence Emergency Management Act 2002) requirements.
• Emergency equipment is accessible, stored correctly, maintained, not expired, and stocked to a level appropriate to the service setting.
• Service providers have policies and procedures on fire safety and emergency management relevant to the service.
• Service providers prominently display evacuation plans or procedures.

Additional guidance

Aged care

• Where applicable, service providers have access to oxygen and suction equipment, which they keep in a state of readiness for use in emergencies.

Fertility services

• Where applicable, service providers have access to oxygen and suction equipment, which they keep in a state of readiness for use in emergencies.

Public/private hospital

• Where applicable, service providers have access to oxygen and suction equipment, which they keep in a state of readiness for use in emergencies.

Birthing units

• Where applicable, service providers have access to oxygen and suction equipment, which they keep in a state of readiness for use in emergencies.

Hospice

• Where applicable, service providers have access to oxygen and suction equipment, which they keep in a state of readiness for use in emergencies.

Criterion 4.2.3

Guidance for all providers

• Service providers consider civil defence requirements, noting a generator is not always available.
• Service providers have business continuity planning or a disaster recovery plan in place. They have evidence that they have trialled it.
• Service providers provide induction and training for health care and support workers around responding to emergency and security situations.
• Service providers monitor the wellbeing of their health care and support workforce during an emergency.
• Selected health care and support workers undertake fire warden training.
• Service providers support people receiving services to maintain their own wellbeing and know what to do in an emergency.

Criterion 4.2.4

Aged care: Guidance

• Relevant health care and support workers have first aid training appropriate to the service.
• A health care and support worker who is trained in first aid works on each shift.
• Enough health care and support workers are available at all times to support people receiving services in an emergency or crisis.

Fertility services: Guidance

• Relevant health care and support workers have first aid training appropriate to the service.
• A health care and support worker who is trained in first aid works on each shift.
• Enough health care and support workers are available at all times to support people receiving services in an emergency or crisis.

Residential disability: Guidance

• Relevant health care and support workers have first aid training appropriate to the service.
• A health care and support worker who is trained in first aid works on each shift.
• Enough health care and support workers are available at all times to support people receiving services in an emergency or crisis.

Residential mental health and alcohol and other drug: Guidance

• Relevant health care and support workers have first aid training appropriate to the service.
• A health care and support worker who is trained in first aid works on each shift.
• Enough health care and support workers are available at all times to support people receiving services in an emergency or crisis.

Hospice: Guidance

• Relevant health care and support workers have first aid training appropriate to the service.
• A health care and support worker who is trained in first aid works on each shift.
• Enough health care and support workers are available at all times to support people receiving services in an emergency or crisis.

Criterion 4.2.5

Aged care: Guidance

• Service providers monitor their call system’s response time and take action to enhance its responsiveness.
• Health care and support workers have access to emergency escalation processes both on site and via an on-call process.
• Service providers have a call system for use as required, which health care and support workers understand clearly and use.

Fertility services: Guidance

• Health care and support workers have access to emergency escalation processes both on site and via an on-call process.
• Service providers have a call system for use as required, which health care and support workers understand clearly and use.

Residential disability: Guidance

• Health care and support workers have access to emergency escalation processes both on site and via an on-call process.
• Service providers have a call system for use as required, which health care and support workers understand clearly and use.

Residential mental health and alcohol and other drug: Guidance

• Service providers monitor their call system’s response time and take action to enhance its responsiveness.
• Health care and support workers have access to emergency escalation processes both on site and via an on-call process.
• Service providers have a call system for use as required, which health care and support workers understand clearly and use.

Public/private hospital: Guidance

• Service providers monitor their call system’s response time and take action to enhance its responsiveness.
• Health care and support workers have access to emergency escalation processes both on site and via an on-call process.
• Service providers have a call system for use as required, which health care and support workers understand clearly and use.

Birthing units: Guidance

• Health care and support workers have access to emergency escalation processes both on site and via an on-call process.
• Service providers have a call system for use as required, which health care and support workers understand clearly and use.

Hospice: Guidance

• Service providers monitor their call system’s response time and take action to enhance its responsiveness.
• Health care and support workers have access to emergency escalation processes both on site and via an on-call process.
• Service providers have a call system for use as required, which health care and support workers understand clearly and use.

Abortion services: Guidance

• Health care and support workers have access to emergency escalation processes both on site and via an on-call process.
• Service providers have a call system for use as required, which health care and support workers understand clearly and use.

Criterion 4.2.6

Guidance for all providers

• Service providers have an implemented policy relating to the security of the people receiving services and the wider facility. The policy includes escalation processes to follow if a breach in security occurs.

Additional guidance

Home and community

• Service providers have implemented policies for:
  1. the safe handling and storage of keys
  2. securing the home.

Residential disability

• People receiving services should, wherever possible, have their own housekey.
• Service providers have implemented policies for:
  1. the safe handling and storage of keys
  2. securing the home.

Criterion 4.2.7

Guidance for all providers (except home and community)

• Service providers meet civil defence emergency requirements.
• The site is able to be operational during emergencies for a period of time. For example, the following supplies are available:
  1. heating
  2. water
  3. emergency lighting
  4. food
  5. alternative communication device with power pack
  6. alternative source of power where oxygen, concentrators, or other electrical equipment is used.

Criterion 4.2.8

Guidance for all providers

• Service providers give information on emergency and security arrangements in accessible formats and through appropriate communication channels, and that are relevant to Māori receiving services and their whānau.
• The information and communication are easy for all people to access, understand, and use, enact, or follow. To meet this criterion, consider Ministry of Health (2015) A Framework for Health Literacy.