There are about 34,000 people living in 715 certified rest homes throughout the country. Older people who live in rest homes are some of the most vulnerable in our society, so it is important to have effective arrangements for checking the quality and safety of rest home services. The effectiveness and efficiency of such arrangements was the focus of a performance audit by my staff.
By law, rest homes have to provide residents with care that meets the Health and Disability Services Standards (the Standards). To provide residential care services for older people, rest homes must be certified by the Director-General of Health and, to remain certified, rest homes must be audited to check whether they meet the many criteria set out in the Standards.
The Ministry of Health (the Ministry) is responsible for the auditing and certification of rest homes. In my view, since its introduction in October 2002, certification of rest homes has not provided adequate assurance that rest homes have met the criteria in the Standards, and the Ministry did not respond quickly enough to address weaknesses and risks in the arrangements that it has known about since 2004.
The Ministry is actively trying to address shortcomings in the effectiveness of auditing and certification arrangements. For example, it has a certification improvement project and wider work programme that have been well managed, and the project has so far met most of its milestones. Communication between all those involved in overseeing rest homes has improved. The Ministry has also begun to manage risks more systematically.
However, more work remains to be done and it is still too early to tell whether the efforts to make the current arrangements work as intended will make a difference or whether certification is fundamentally unable to do what the legislation envisaged.
Purpose
We carried out a performance audit of the arrangements designed to check that the care older people receive in rest homes meets the required standards of safety and quality.