Summerville Rest Home
Profile & contact details
| Premises name | Summerville Rest Home |
|---|---|
| Address | 411 Frederick Street Mahora Hastings 4120 |
| Total beds | 15 |
| Service types | Rest home care |
| Certification/licence name | Sunflower Field Trading NZ Limited - Summerville Rest Home |
|---|---|
| Current auditor | Health and Disability Auditing New Zealand Limited |
| End date of current certificate/licence | 09 December 2024 |
| Certification period | 36 months |
| Provider name | Sunflower Field NZ Limited |
|---|---|
| Street address | 411 Frederick Street Mahora Hastings 4120 |
| Post address | 19A Knightsbridge Drive Forrest Hill Auckland 0620 |
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: 10 May 2023
| Outcome required | Found at audit | Action required | Risk rating | Action status | Date action reported complete |
|---|---|---|---|---|---|
| Service providers receive appropriate information, training, and equipment to respond to identified emergency and security situations. This shall include fire safety and emergency procedures. | There is not always a first aid trained staff member on duty 24/7 as staff first aid certificates expired on 7 August 2021. | Ensure that there is a first aid trained staff member on duty 24/7 and that staff have current first aid certificates. | PA Moderate | Reporting Complete | 06/12/2021 |
| 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. | i) Care plan reviews in all five files reviewed did not reflect resident and/or relative input. ii) Documentation does not reflect resident progression towards meeting goals in all five files . | Ensure the care plan review documents resident, relative input and evidences residents’ progression towards meeting care plan goals. | PA Low | Reporting Complete | 06/12/2021 |
| A system to identify, plan, facilitate, and record ongoing education for service providers to provide safe and effective services to consumers. | Not all compulsory training included in the two-yearly education planner has been completed. Compulsory training not completed includes abuse and neglect, cultural awareness, the code, privacy/dignity, sexuality/intimacy, spirituality/counselling, chemical safety, challenging behaviour, dementia and falls prevention. | Ensure that all compulsory staff training included in the two-yearly education planner is completed. | PA Low | Reporting Complete | 06/12/2021 |
| Each stage of service provision (assessment, planning, provision, evaluation, review, and exit) is provided within time frames that safely meet the needs of the consumer. | (i) Four of six resident files reviewed did not have interRAI assessments completed or reviewed within expected timeframes. (ii) Progress notes for two residents who have had an incident report completed did not evidence follow-up by the registered nurse. | (i) Ensure interRAI assessments are completed in a timely manner. (ii) Ensure progress notes document RN follow-up of incidents. | PA Low | Reporting Complete | 06/12/2021 |
| Service delivery plans describe the required support and/or intervention to achieve the desired outcomes identified by the ongoing assessment process. | i) One resident has had a decline in condition which was well documented in the progress notes, however, the extra support and assistance the resident required was not documented in the long-term care plan. ii) One resident identified as Māori and is Catholic. There were no interventions included in the cultural/spiritual section of the care plan around resident preferences or affiliations, or spiritual practices including whether the priest visited for communion. iii) One resident has a diagn… (this text has been trimmed due to space limits). | (i)-(iii) Ensure there are individualised interventions documented to meet all resident needs. | PA Low | Reporting Complete | 06/12/2021 |
| Consumers have a right to full and frank information and open disclosure from service providers. | Fifteen accident/incident forms were reviewed for June, July, and August 2021. There was no documented notification to the next of kin for 14 of 15 accident/incident forms reviewed. | Ensure that documentation reflects that next of kin are notified of any resident incidents/accidents or if not notified, the reason why should be documented. | PA Moderate | Reporting Complete | 06/12/2021 |
| Activities are planned and provided/facilitated to develop and maintain strengths (skills, resources, and interests) that are meaningful to the consumer. | i) There was no documentation of daily activities that have taken place. ii) There was no activities assessment or plan documented for two of five residents. iii) Three of five residents did not have a six-monthly review of their activities plan. | i) Ensure there is a record of all resident activities maintained. ii-iii) Ensure all residents have a current activity assessment, and plan documented tailored to residents’ preferences, which is reviewed at least six-monthly. | PA Low | Reporting Complete | 06/12/2021 |
| 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. | The temperature of the medication room has not been recorded to evidence the temperature is maintained at less than 25 degrees. | Ensure the medication room temperatures are recorded daily. | PA Low | Reporting Complete | 06/12/2021 |
| Key components of service delivery shall be explicitly linked to the quality management system. | There have been no staff/quality meetings or resident meetings documented as held for 2021 year to date. | Ensure meetings are held as scheduled. | PA Low | Reporting Complete | 07/06/2022 |
| Service providers shall develop and implement a quality management framework using a risk-based approach to improve service delivery and care. | (i) There are no documented staff meetings since May 2022, and no documented resident meetings. (ii) There is evidence of only one internal audit being completed since 2021. | (i) Ensure regular meetings are held and clearly documented with any actions arising being addressed and signed off. (ii) Ensure audits are carried out as per schedule, corrective actions are implemented for any areas of non-compliance. | PA Moderate | Reporting Complete | 04/12/2023 |
| 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. | There was no documented evidence of hot water temperature monitoring. | Ensure water temperatures are measured and within the required safe ranges for resident use. | PA Low | Reporting Complete | 05/12/2023 |
| Service providers shall ensure there is a system to identify, plan, facilitate, and record ongoing learning and development for health care and support workers so that they can provide high-quality safe services. | Compulsory training not completed includes abuse and neglect, the code of rights, privacy/dignity, sexuality/intimacy, spirituality/counselling, chemical safety, challenging behaviour, the ageing process, dementia and falls prevention. | Ensure that all compulsory staff training included in the two-yearly education planner is completed. | PA Moderate | Reporting Complete | 05/12/2023 |
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: 10 May 2023Audit type:Surveillance Audit
Audit date: 29 September 2021Audit type:Certification Audit
Audit date: 21 September 2018Audit type:Certification Audit
Audit date: 25 October 2017Audit type:Surveillance Audit
Audit date: 13 October 2016Audit type:Certification Audit