Craigweil House

Profile & contact details

Premises details
Premises nameCraigweil House
Address 147 Parkhurst Road Parakai 0830
Total beds68
Service typesDementia care, Rest home care, Geriatric
Certification/licence details
Certification/licence nameHenrikwest Management Limited - Craigweil House
Current auditorThe DAA Group Limited
End date of current certificate/licence06 September 2020
Certification period24 months
Provider details
Provider nameHenrikwest Management Limited
Street address 663 Mount Albert Road Royal Oak Auckland 1023
Post address663 Mt Albert Road Royal Oak Auckland 1023

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: 06 June 2019

Outcome requiredFound at auditAction requiredRisk ratingAction statusDate action reported complete
The provision of services and/or interventions are consistent with, and contribute to, meeting the consumers' assessed needs, and desired outcomes.Care plans do not include specific individualised strategies and interventions to meet the needs of residents identified through the assessment process. Specific interventions and documentation around the use of a specific piece of equipment for one resident was inadequate (a lack of monitoring /usage and outcome of use of this device) given the complexity of need for the resident. Ensure that care plans are individualised to meet needs identified in the assessment process. Identify specific interventions for the use of CPAP to meet resident need and implement (note that this issue should be addressed as soon as possible). PA ModerateReporting Complete19/11/2018
The organisation is managed by a suitably qualified and/or experienced person with authority, accountability, and responsibility for the provision of services.There is a lack of clarity around who holds the role of ‘facility’ manager. Provide clarity around who holds the role of facility manager. PA ModerateReporting Complete17/12/2018
Information of a private or personal nature is maintained in a secure manner that is not publicly accessible or observable.Information on a whiteboard in the nurses’ station can be publicly observed. Ensure that resident information is not publicly observable. PA LowReporting Complete17/12/2018
A medicines management system is implemented to manage the safe and appropriate prescribing, dispensing, administration, review, storage, disposal, and medicine reconciliation in order to comply with legislation, protocols, and guidelines.Time of administration of controlled drugs is not consistently documented in the controlled drug register. The impress system and stock is not checked at regular intervals. Document the time of administration of controlled drugs in the controlled drug register. Check the impress system and stock. PA ModerateReporting Complete17/12/2018
The needs, outcomes, and/or goals of consumers are identified via the assessment process and are documented to serve as the basis for service delivery planning.The interRAI assessment is not completed prior to the care plans being documented in all seven resident files reviewed. There is currently no system to identify key clinical issues particularly related to weight loss documented in the interRAI assessment for a group of residents. Complete the interRAI assessment prior to the care plan being documented and use as a basis for care planning. Use the assessment to inform the care planning for residents losing weight and develop and implement a system to monitor residents as a group who are losing weight with evidence that service delivery is changed to meet resident needs. PA ModerateReporting Complete17/12/2018
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.Not all files sampled provided evidence of a documented evaluation of the long-term care plan. Evaluate each long-term prior to the new care plan being documented. PA ModerateReporting Complete17/12/2018
Service providers have access to designated areas for the safe and hygienic storage of cleaning/laundry equipment and chemicals.Areas identified as clean and dirty were not adhered to on the days of audit. Chemicals were sighted in rooms that were not locked on the days of audit including the sluice room, some bathrooms. Provide training to staff to ensure that clean and dirty areas are used appropriately and monitor to ensure that this occurs. Ensure that chemicals are stored and safe secure areas when not in use. PA ModerateReporting Complete17/12/2018
New service providers receive an orientation/induction programme that covers the essential components of the service provided.The orientation programme does not specifically differentiate between different levels of care provided (rest home, hospital, dementia unit). Document an orientation programme that includes orientation to different levels of care and support. PA LowReporting Complete29/01/2019
A system to identify, plan, facilitate, and record ongoing education for service providers to provide safe and effective services to consumers.Documentation of attendance for training sessions at times shows that there is a low attendance and another system to support staff who cannot attend to access training is not in place. Develop a process to provide training to staff who are unable to attend training offered and implement. PA LowReporting Complete29/01/2019
Adequate space is provided to allow the consumer and service provider to move safely around their personal space/bed area. Consumers who use mobility aids shall be able to safely maneuvers with the assistance of their aid within their personal space/bed area.Two rooms for residents requiring hospital level care are not suitable for cares to be provided given the complexity of need and acuity of the residents. Review the needs and acuity of residents requiring hospital level of care to confirm that cares are able to provided safely and as per individual need. PA ModerateReporting Complete29/01/2019
Approved restraint is only applied as a last resort, with the least amount of force, after alternative interventions have been considered or attempted and determined inadequate. The decision to approve restraint for a consumer should be made: (a) Only as a last resort to maintain the safety of consumers, service providers or others; (b) Following appropriate planning and preparation; (c) By the most appropriate health professional; (d) When the environment is appropriate and safe for successful … (this text has been trimmed due to space limits).Two out of three resident records did not evidence monitoring of use of restraint as per the care plan. There is an ability to lock bedrooms of residents in the dementia unit. Ensure that staff monitor residents using restraints as stated in the care plan. Ensure that residents can freely access their own rooms at any time. PA LowReporting Complete12/02/2019
Quality improvement data are collected, analysed, and evaluated and the results communicated to service providers and, where appropriate, consumers.There is insufficient evidence in meetings minutes to confirm that quality related data is analysed, discussed and used to improve service delivery. Document evidence of discussion and analysis of quality related data that is then used to improve service delivery. PA ModerateReporting Complete12/02/2019
A process to measure achievement against the quality and risk management plan is implemented.The laundry, kitchen and activities meetings are not held monthly as planned. Review the frequency of meetings and implement the meeting schedule as planned. PA LowReporting Complete12/02/2019
A corrective action plan addressing areas requiring improvement in order to meet the specified Standard or requirements is developed and implemented.Corrective action plans are not always documented when issues are raised and there is not always evidence of resolution of issues. The administration manager completes internal audits including clinically based audits including reporting of results to management but is not clinically trained. Document corrective action plans when issues are raised with evidence of resolution of issues including addressing of resident issues in a safe and appropriate manner. Provide opportunities for clinical staff to have input into the internal audit programme particularly when there are internal audits involving clinical care. PA ModerateReporting Complete12/02/2019
A corrective action plan addressing areas requiring improvement in order to meet the specified Standard or requirements is developed and implemented.Corrective action plans are not always documented when issues are raised and there is not always evidence of resolution of issues. The administration manager completes internal audits including clinically based audits including reporting of results to management but is not clinically trained. Document corrective action plans when issues are raised with evidence of resolution of issues including addressing of resident issues in a safe and appropriate manner. Provide opportunities for clinical staff to have input into the internal audit programme particularly when there are internal audits involving clinical care. PA ModerateReporting Complete25/03/2019
A process to measure achievement against the quality and risk management plan is implemented.The laundry, kitchen and activities meetings are not held monthly as planned. Review the frequency of meetings and implement the meeting schedule as planned. PA LowReporting Complete25/03/2019
Approved restraint is only applied as a last resort, with the least amount of force, after alternative interventions have been considered or attempted and determined inadequate. The decision to approve restraint for a consumer should be made: (a) Only as a last resort to maintain the safety of consumers, service providers or others; (b) Following appropriate planning and preparation; (c) By the most appropriate health professional; (d) When the environment is appropriate and safe for successful … (this text has been trimmed due to space limits).Not all staff have received the required education for restraint minimisation and safe practice. There is still an ability to lock bedrooms of residents in the dementia service. Further education is required for all staff on restraint minimisation and safe practice. Ensure residents can freely access their own rooms at any time. PA LowReporting Complete25/03/2019
Quality improvement data are collected, analysed, and evaluated and the results communicated to service providers and, where appropriate, consumers.There is insufficient evidence in meetings minutes to confirm that quality related data is analysed, discussed and used to improve service delivery. Document evidence of discussion and analysis of quality related data that is then used to improve service delivery. PA ModerateReporting Complete26/06/2019

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: 06 June 2019

Audit type:Surveillance Audit

Audit date: 19 December 2018

Audit type:Partial Provisional Audit

Audit date: 20 June 2018

Audit type:Certification Audit

Audit date: 03 July 2017

Audit type:Provisional Audit

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