Ultimate Care Palliser House
Profile & contact details
|Premises name||Ultimate Care Palliser House|
|Address||186 East Street Greytown 5712|
|Service types||Medical, Dementia care, Rest home care|
|Certification/licence name||The Ultimate Care Group Limited - Ultimate Care Palliser House|
|Current auditor||Central Region's Technical Advisory Services Limited|
|End date of current certificate/licence||01 September 2021|
|Certification period||Other months|
|Provider name||The Ultimate Care Group Limited|
|Street address||Level 2 111 Johnsonville Road Johnsonville Wellington 6037|
|Post address||PO Box 425 Waterloo Quay Wellington 6140|
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: 21 January 2021
|Outcome required||Found at audit||Action required||Risk rating||Action status||Date action reported complete|
|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.||Not all residents had an initial GP assessment within the required timeframe following admission.||Ensure that all residents are assessed by a GP within the required timeframe following admission.||PA Moderate||In Progress|
|Professional qualifications are validated, including evidence of registration and scope of practice for service providers.||Staff performance appraisals are inconsistently completed.||Ensure all staff performance appraisals are completed in a timely manner.||PA Low||In Progress|
|Service providers have access to designated areas for the safe and hygienic storage of cleaning/laundry equipment and chemicals.||Clean laundry is transported without protective cover.||Ensure protection of clean laundry during transport.||PA Low||Reporting Complete||30/03/2021|
|Service providers follow a documented process for the safe and appropriate storage and disposal of waste, infectious or hazardous substances that complies with current legislation and territorial authority requirements.||The hazard register was not current.||Ensure the hazard register is updated at least annually.||PA Low||Reporting Complete||30/03/2021|
|All buildings, plant, and equipment comply with legislation.||i) Not all firefighting equipment demonstrated evidence of a current check. ii) Temperatures of the refrigerators located in residents’ rooms are not monitored. iii) Plan to secure the outdoor area in the dementia unit needs to be implemented.||i) Ensure all firefighting equipment demonstrates evidence of a current check. ii) Ensure temperatures of the refrigerators located in residents’ rooms are monitored. iii) Ensure plan to secure outdoor area in the dementia unit is implemented.||PA Moderate||Reporting Complete||30/03/2021|
|There are adequate numbers of accessible toilets/showers/bathing facilities conveniently located and in close proximity to each service area to meet the needs of consumers. This excludes any toilets/showers/bathing facilities designated for service providers or visitor use.||Privacy locks are not always available on communal showers’ and toilets’ doors.||Provide privacy locks on all communal showers’ and toilet doors.||PA Low||Reporting Complete||30/03/2021|
|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.||i) The use-by-date of medications with a reduced shelf live after opening is not always recorded. ii) The medication room temperature is not monitored.||i) Ensure the use-by-date of medications with a reduced shelf live after opening is recorded. ii) Ensure the drug room temperature is monitored and documented.||PA Moderate||Reporting Complete||30/03/2021|
|Activities are planned and provided/facilitated to develop and maintain strengths (skills, resources, and interests) that are meaningful to the consumer.||i) Activities are not implemented on the four days per week that the activity coordinator is not at the facility. ii) Care plans for dementia care residents do not describe interventions, strategies or activities to manage challenging behaviours or to provide diversion over a 24 hour period.||i) Ensure that planned activities are implemented and documented on the days that the activity coordinator is not at the facility. ii) Ensure long term care plans of the residents living in the dementia unit include strategies, interventions and activities for managing challenging behaviours, as well as a 24 hour period activities plan.||PA Moderate||Reporting Complete||30/03/2021|
The outcome required by the Health and Disability Services Standards.
Found at audit
The issue that was found when the rest home was audited.
The action necessary to fix the issue, as decided by the auditor.
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.
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.
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 reportsAudit date: 21 January 2021
Audit type:Partial Provisional Audit
- Ultimate Care Palliser House - Jan 2021 (docx, 53.54 KB)
- Ultimate Care Palliser House - Jan 2021 (pdf, 136.25 KB)
Audit type:Surveillance Audit
- Ultimate Care Palliser House - Dec 2019 (docx, 41.43 KB)
- Ultimate Care Palliser House - Dec 2019 (pdf, 164.14 KB)
Audit type:Partial Provisional Audit