Leslie Groves Hospital
Profile & contact details
Premises name | Leslie Groves Hospital |
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Address | 321 Taieri Road Halfway Bush Dunedin 9010 |
Total beds | 75 |
Service types | Psychogeriatric, Geriatric, Medical, Dementia care |
Certification/licence name | Leslie Groves Society of St John's (Roslyn) - Leslie Groves Hospital |
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Current auditor | Health and Disability Auditing New Zealand Limited |
End date of current certificate/licence | 13 September 2024 |
Certification period | 36 months |
Provider name | Leslie Groves Society of St John's (Roslyn) |
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Street address | 321 Taieri Road Halfway Bush Dunedin 9010 |
Post address |
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: 25 September 2023
Outcome required | Found at audit | Action required | Risk rating | Action status | Date action reported complete |
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Buildings, plant, and equipment shall be fit for purpose, and comply with legislation relevant to the health and disability service being provided. The environment is inclusive of peoples’ cultures and supports cultural practices. | (i) The CPU certificate is still to be issued. (ii) The existing medication room in Taieri was in the process of refurbishment and not yet fully complete. (iii) The flooring was not fully installed in the rooms, kitchenette, and communal areas. (iv) Heating was not yet fully installed. (v) Handrails in the corridors need to be installed (vi) Lighting and heating still need to be installed (vii) One entrance from Redwood that is boarded off is not completed and keypad activated (viii) There … (this text has been trimmed due to space limits). | (i) Ensure the CPU is obtained. (ii) – (vi) Ensure communal areas and resident rooms are fully furnished. (vii-viii) Ensure Redwood entrance is keypad activated when the construction board is removed. (viii) Ensure construction boarding at existing room 62 and 50 are removed for safe passage. (ix) Ensure water temperatures to resident areas are monitored and below 45 degrees. (x) Ensure safe egress as part of the fire evacuation plan. (xi) Flowing soap, handtowels and alcogel to be installed. … (this text has been trimmed due to space limits). | PA Low | Reporting Complete | 14/11/2023 |
Where required by legislation, there shall be a Fire and Emergency New Zealand- approved evacuation plan. | A fire evacuation plan is documented and has been lodged for approval with the New Zealand Fire Service. | Ensure the fire evacuation scheme is approved. | PA Low | Reporting Complete | 14/11/2023 |
Health care and support workers shall receive appropriate information, training, and equipment to respond to identified emergency and security situations. This shall include fire safety and emergency procedures. | A fire drill training is to be completed for staff to include the new extension. | Ensure a fire drill training is completed for staff prior to opening. | PA Low | Reporting Complete | 14/11/2023 |
An appropriate call system shall be available to summon assistance when required. | The call bells and motion sensors were not yet operational. | Ensure the call bells system is activated and operational. | PA Low | Reporting Complete | 14/11/2023 |
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.
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.
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 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) 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: 25 September 2023Audit type:Partial Provisional Audit
- Leslie Groves Hospital - Sep 2023 (docx, 50.33 KB)
- Leslie Groves Hospital - Sep 2023 (pdf, 161.44 KB)
Audit type:Surveillance Audit
- Leslie Groves Hospital - Mar 2023 (docx, 56.56 KB)
- Leslie Groves Hospital - Mar 2023 (pdf, 177.01 KB)
Audit type:Certification Audit
- Leslie Groves Hospital - Jul 2021 (docx, 43.8 KB)
- Leslie Groves Hospital - Jul 2021 (pdf, 172.54 KB)
Audit type:Surveillance Audit
- Leslie Groves Hospital - Jan 2020 (docx, 38.49 KB)
- Leslie Groves Hospital - Jan 2020 (pdf, 151.8 KB)
Audit type:Certification Audit
- Leslie Groves Hospital - Jul 2018 (docx, 42.03 KB)
- Leslie Groves Hospital - Jul 2018 (pdf, 167.21 KB)
Audit type:Surveillance Audit