Premise details
- Address
- 164 Oxford Street South Dunedin Dunedin 9012
- Total beds
- 72
- Service types
- Geriatric, Medical, Rest home care
Certification/licence details
- Certification/licence name
- Oxford Court Limited - Oxford Court
- Current auditor
- The DAA Group Limited
- End date of current certificate/licence
- Certification period
- 36 months
Provider details
- Provider name
- Oxford Court Limited
- Street address
- Level 5 25 Broadway Newmarket Auckland 1023
- Postal address
- PO Box 56114 Dominion Road Auckland 1446
Progress on issues from the last audit
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.
| Outcome required | Found at audit | Action required | Risk rating | Action status | Date action reported complete |
|---|---|---|---|---|---|
| The physical environment, internal and external, shall be safe and accessible, minimise risk of harm, and promote safe mobility and independence. | One of the stairwells had mobility equipment stored at the top of the stairs blocking safe egress. | Provide evidence that all stairwells and emergency exits are free from clutter. | PA Moderate | Reporting Complete | |
| In implementing care or support plans, service providers shall demonstrate: (a) Active involvement with the person receiving services and whānau; (b) That the provision of service is consistent with, and contributes to, meeting the person’s assessed needs, goals, and aspirations. Whānau require assessment for support needs as well. This supports whānau ora and pae ora, and builds resilience, self-management, and self-advocacy among the collective; (c) That the person receives services that remov | Dcoumentation from five unwitnessed falls reviewed did not have neurological observations consistently completed as per policy requirements. | Ensure all neurological observations are consistently completed post unwitnessed falls or head injuries as per policy requirements. | PA Moderate | Reporting Complete | |
| Planned review of a person’s care or support plan shall: (a) Be undertaken at defined intervals in collaboration with the person and whānau, together with wider service providers; (b) Include the use of a range of outcome measurements; (c) Record the degree of achievement against the person’s agreed goals and aspiration as well as whānau goals and aspirations; (d) Identify changes to the person’s care or support plan, which are agreed collaboratively through the ongoing re-assessment and review | Five of eight long term care plans reviewed were not updated in a timely manner following interRAI assessments. | Ensure long-term care plans are evaluated following interRAI assessments. | PA Moderate | Reporting Complete | |
| Service providers shall ensure there are sufficient health care and support workers on duty at all times to provide culturally and clinically safe services. | There are insufficient RNs employed to provide RN care at the facility 24 hours a day, seven days a week (24/7). This does not meet the requirements of the aged residential care contract. | Ensure that there is at least one RN on site 24/7. | PA Low | Reporting Complete | |
| Service providers shall engage with people receiving services to assess and develop their individual care or support plan in a timely manner. Whānau shall be involved when the person receiving services requests this. | Not all timeframes for the completion of initial care planning, interRAI assessment and long-term care planning met policy and contractually required timeframes. | Ensure all residents have an initial care plan completed with 24 hours of admission as required by policy and that all long-term residents have an interRAI assessment and long-term care plan completed with 21 days of admission as required by the provider’s contract with Health New Zealand Southern. | PA Moderate | In Progress | |
| A medication management system shall be implemented appropriate to the scope of the service. | Not all elements of the medication management system met the expected standard for the safe administration of medications. | The service will ensure medications are labelled correctly with a pharmacy label including the prescriber’s name and prescription details and that individually dispensed medications are not used as communal stock. | PA Low | In Progress | |
| Service providers shall have a clearly defined and documented IP programme that shall be: (a) Developed by those with IP expertise; (b) Approved by the governance body; (c) Linked to the quality improvement programme; and (d) Reviewed and reported on annually. | There was no evidence of annual review or reporting against the IP programme. | Ensure the newly developed IP programme is reviewed and reported on annually. | PA Low | In Progress | |
| Planned review of a person’s care or support plan shall: (a) Be undertaken at defined intervals in collaboration with the person and whānau, together with wider service providers; (b) Include the use of a range of outcome measurements; (c) Record the degree of achievement against the person’s agreed goals and aspiration as well as whānau goals and aspirations; (d) Identify changes to the person’s care or support plan, which are agreed collaboratively through the ongoing re-assessment and review | Changes required to a resident’s care or support plan are not always identified through the ongoing assessment and review process, and updates to the care plan are not always made to reflect the resident's needs. | Ensure resident care plans are updated following interRAI assessment and when changes to a resident's needs are identified through the ongoing assessment and review process. | PA Moderate | In Progress | |
| Health care and support workers shall receive an orientation and induction programme that covers the essential components of the service provided. | Five of the seven staff files had no evidence of completed orientation. | Ensure orientation is completed for all staff as per policy and standard requirements. | PA Low | In Progress | |
| I shall give informed consent in accordance with the Code of Health and Disability Services Consumers’ Rights and operating policies. | Files reviewed evidenced not all residents had given informed consent to care. Two out of seven residents reviewed did not have documentation on file and for a further two residents there was no evidence they had been included in discussion and decision-making regarding their care. | Ensure all residents have a documented informed consent on file and ensure there is evidence all residents who are cognitively able are involved in discussions and decisions regarding their care. | PA Low | In 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
About audit reports
Audit reports for this rest home’s latest audits can be downloaded below.
Before you begin
Before you download the audit reports, please read our guide to rest home certification and audits. The guide gives an overview of the auditing process and explains what the audit reports mean.
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.
From 1 June 2009 to 28 February 2022 rest homes were audited against the Health and Disability Services Standards NZS 8134:2008. These standards have been updated, and from 28 February 2022 rest homes are audited against Ngā Paerewa Health and Disability Services Standard NZS 8134:2021.
Before 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 Ngā Paerewa Health and Disability Services Standard.
Note: From November 2013, as rest homes are audited, any issues from their latest audit (the corrective actions required by the auditor) appear on the rest home’s page. As the rest home completes the required actions, the status on the website updates.
Audit date:
Audit type: Certification Audit
Audit date:
Audit type: Provisional Audit
