Windsor Park Specialist Senior Care Centre

Profile & contact details

Premises details
Premises nameWindsor Park Specialist Senior Care Centre
Address 3 McKellar Street Gore 9710
Total beds79
Service typesGeriatric, Medical, Physical, Dementia care, Rest home care
Certification/licence details
Certification/licence nameBupa Care Services NZ Limited - Windsor Park Specialist Senior Care Centre
Current auditorHealth and Disability Auditing New Zealand Limited
End date of current certificate/licence30 October 2021
Certification period48 months
Provider details
Provider nameBupa Care Services NZ Limited
Street addressLevel 2 109 Carlton Grove Road Newmarket Auckland 1023
Post addressPO Box 113054 Newmarket Auckland 1149
Websitewww.bupa.co.nz/

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: 13 November 2019

Outcome requiredFound at auditAction requiredRisk ratingAction statusDate action reported complete
Results of surveillance, conclusions, and specific recommendations to assist in achieving infection reduction and prevention outcomes are acted upon, evaluated, and reported to relevant personnel and management in a timely manner.(i). There was no documented evidence of IC statistics from January to June 2019. (ii). From June to present IC statistics have been collected, but there is no analysis of data and no reporting of trends. (iii). There was no documented evidence of benchmarking with other Bupa facilities as per policy. (i)-(iii). Ensure statistics collated, evidence analysis and reporting of trends (if any identified). Ensure benchmarking with other Bupa facilities occurs. PA ModerateIn Progress
New service providers receive an orientation/induction programme that covers the essential components of the service provided.Five staff files were reviewed, no role-specific orientation was evident on staff files. None of the five staff files reviewed had evidence of a current appraisal. Ensure all staff have role-specific orientation completed, and evidence appraisals as per policy. PA LowIn Progress
Quality improvement data are collected, analysed, and evaluated and the results communicated to service providers and, where appropriate, consumers.(i) Meetings are not held according to the schedule; quality, staff meetings, health and safety and restraint. (ii) Minutes of meetings held do not discuss quality data analysis or trending around infection control, incidents/accidents, internal audit results. (i)-(ii) Ensure meetings are held according to the schedule and there is evidence of analysis and trending discussed. PA LowReporting Complete25/06/2020
Actual and potential risks are identified, documented and where appropriate communicated to consumers, their family/whānau of choice, visitors, and those commonly associated with providing services. This shall include: (a) Identified risks are monitored, analysed, evaluated, and reviewed at a frequency determined by the severity of the risk and the probability of change in the status of that risk; (b) A process that addresses/treats the risks associated with service provision is developed and im… (this text has been trimmed due to space limits).(i). The hazard register has not been reviewed at least annually. (ii). There has been no health and safety training provided to staff. (i).- (ii). Ensure the hazards register is reviewed at least annually, and training on health and safety is provided as per schedule. PA LowReporting Complete25/06/2020

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.

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