Rest home audits and how to read them

The Ministry of Health pages behind this guide were last updated between 2015 and 2024, and some could only be read from archived copies. The system may have changed since, so check anything important with the Ministry of Health or the home.

Who checks rest homes

Every rest home and hospital must be certified under the Health and Disability Services (Safety) Act 2001. The Ministry's pages describe HealthCERT, part of the Ministry of Health, as running this system: it issues certificates, reviews audit reports and enforces the law.

The audits themselves are carried out by designated auditing agencies. These are organisations approved to audit health and disability providers.

The standard homes are measured against

Since 28 February 2022, homes have been audited against the Ngā Paerewa Health and Disability Services Standard (NZS 8134:2021). It replaced the earlier 2008 standards. When you read a recent audit report, this is the standard each finding refers to.

How certification works

After a certification audit, a rest home is certified for a set period. The Ministry says this is usually between one and four years, and the length depends on how well the home performed at the audit. When the period ends, the home must be audited again to renew its certificate.

The law sets the outer limits. A certificate can last no more than 5 years. It cannot be set for more than 3 years unless the provider is already certified and has been improving the quality of its services, and is likely to keep improving.

As general guidance, the length of the certification period is a useful signal, because it reflects the audit result. If a home has a short period, ask why. A home that has recently changed owners will have a one-year certificate after its provisional audit, so a short period is not always a warning sign.

The Director-General of Health must cancel a provider's certification if satisfied that the provider does not meet the relevant standards.

The types of audit

• Certification audit. The main audit. It checks whether the home meets the standards and leads to its certificate.
• Surveillance audit, or spot audit. Carried out part-way through the certification period, with one at the midpoint and sometimes more. For aged residential care these are always unannounced. They focus on how care is delivered and on anything not fully met at the last audit.
• Provisional audit. Carried out when a provider buys a certified rest home. The new owner gets a certificate for one year.
• Partial provisional audit. Carried out when a provider adds a service, such as a rest home adding hospital-level care, builds a new home, adds a wing or upgrades rooms.

How to read an audit report

Each standard or criterion in the report gets a rating. This is how the Ministry described the ratings in 2015:

Anything rated PA or UA is also given a risk rating, based on the potential risk to residents. The five levels are negligible, low, moderate, high and critical.

Where improvement is needed, the report includes a corrective action request, or CAR. This states what the home must fix and the timeframe for fixing it.

Do not be alarmed by a PA on its own. The Ministry's 2015 guidance says a partial attainment rating does not indicate a failure, and that most rest home audits have some. The risk rating tells you more than the letter code.

General guidance on what to look for:

• the length of the certification period
• any findings rated moderate, high or critical risk
• the same problem showing up in more than one audit
• whether the corrective actions from the last audit were closed
• the findings of the most recent spot audit, because it was unannounced
• a recent provisional audit, which means the home has changed owners.

Where to find reports

The Ministry of Health has published audit reports for rest homes in its database of certified providers. Full reports are available for audits from late 2013. For earlier audits, only summary reports exist.

The way reports are published may have changed since those pages were written. If you cannot find a home's report, ask the home for a copy of its latest audit report, or contact HealthCERT at the Ministry of Health.

Questions to ask

• When was your last audit, and what type was it?
• How long is your current certification period, and when does it end?
• Were any findings rated moderate, high or critical risk? Have those corrective actions been closed?
• Has the home changed owners, or added services, recently?
• Can I see your most recent full audit report?