MEDIA RELEASE
10 April 2006
Please attribute to Dr Colin Feek, Deputy Director General
The Director General of Health has cancelled the certification of Culverden Group Limited, trading in Mangere as
Pasifika Centre and Hospital, because of its failure to satisfy the Director General that it meets the relevant service
standards required for such facilities.
Culverden's certification is to provide Hospital Care (medical services and geriatric services) and Rest Home Care.
The 101 residents and their families are being informed of the decision and what it will mean for them.
The Ministry of Health and the Counties Manakau District Health Board are considering issues around moving the residents
of the Pasifika Centre and Hospital into alternative accommodation.
A temporary manager, appointed by the Ministry of Health and the Counties Manukau District Health Board, has been
managing the Pasifika Centre and Hospital since early last month. This was in order to provide the Ministry and the DHB
with a level of assurance about the care residents receive and the facility's compliance with the relevant standards
under the Health and Disability Services (Safety) Act 2001.
Culverden Group Ltd has been the subject of three Ministry inspections in the past 15 months, which have raised serious
and ongoing concerns about its compliance with those standards. While an independent audit report by a Designated
Auditing Agency indicated that the intent of the standards was being met, their audit report also identified a number of
risk areas.
The Ministry's preference would have been to see Culverden Group Ltd meet the standards, enabling the 101 residents to
remain at the centre and hospital, but in the current circumstances the Ministry believes that is not possible.
The Ministry sees compliance with the standards as a vital part of ensuring the safety and quality of care for
residents, which is a paramount consideration for the Ministry.
Culverden has the right to appeal the Director General's decision and can apply for a suspension of the revocation of
its certificate.
Ends
BACKGROUND
QUESTIONS AND ANSWERS
* What is the relevant law and the process followed?
Health care providers are certified under the Health and Disability Services (Safety) Act 2001 to provide rest home
care, hospital services and residential disability support services.
The purpose of the Health and Disability Services (Safety) Act 2001 is to promote the safe provision of health and
disability services to the public and to encourage providers to improve continuously the quality of these services.
Under the Act, the Director General of Health issues certificates for providers to operate. To apply for certification,
providers must be audited against standards that the Minister of Health approves. The auditors are independent,
designated auditing agencies. The maximum period a provider can be certified for is five years.
The Director General is the only person who can cancel certification.
In December 2005 Culverden Group Ltd was certified for six months on the basis of an audit report by designated auditing
agency, Bureau Veritas Quality International.
For more general information on the certification process go to www.moh.govt.nz/certification
Under the Health and Disability Services (Safety) Act 2001 providers of hospitals, old peoples' homes and disabled
peoples' community welfare homes, who wished to continue to operate, were required to meet the requirements of the Act
by September 2004 to become certified. The requirements have lifted the bar for these health care providers.
The Ministry of Health believes that the implementation of the Health and Disability Services (Safety) Act 2001, since
October 2004, is leading to overall improvements in standards in the residential care sector in New Zealand.
*What inspections has Culverden been subject to and why?
Under the Act, the Director General may authorise Ministry of Health staff to enter and inspect a premises if there are
concerns about residents' safety.
December 2004
The first unannounced inspection of Culverden took place in December 2004 following the receipt of two complaints
alleging inadequate care of residents.
The December inspection listed 101 required corrective actions in relation to the relevant standards for certification.
Among these were issues related to a lack of registered nurse input, issues related to Health and Disability Sector
standards, aspects of the Infection Control Standard and the Restraint Minimisation and Safe Practice Standard.
For example, pain management was poor and several clients identified as "in pain'' had inadequate or no pain management
strategies in place.
As a result of the inspection, there was agreement between the Ministry and the provider representatives for both
parties to work together to remedy the situation. Culverden Group Ltd made a number of changes - for example, one of its
buildings was closed down because the Ministry believed it was substandard and unsuitable in its present state for
residential care. Following concerns raised about its management structure a new chief executive and executive officer
were appointed.
Between December 2004 and July 2005, Culverden Group Ltd provided written documentation to the Ministry of Health about
changes to its policies and procedures.
June 2005
In June 2005 a second unannounced inspection took place to check the progress made to meet the requirements outlined in
the December report. The July report found 41 corrective actions from the December inspection had been addressed while
58 remained active (two were unable to be assessed).
The inspection team acknowledged progress towards making improvements, including major restructuring at management and
senior registered nurse levels and improved reporting systems but found a number of significantly high-risk areas still
needed to be addressed. The most urgent of these was inadequate input by health professionals, in particular a
registered nursing shortage.
The Ministry required Culverden Group Ltd to address the registered nursing shortage within four weeks and to provide a
detailed management plan within a month about how it would address the outstanding corrective actions. Culverden Group
Ltd was required to provide a progress report every two months.
February 2006
In February 2006 a third unannounced inspection was carried out. The purpose of this inspection was to confirm
corrective actions had been addressed and because of reported changes to management.This inspection was unable to
substantiate the implementation of any significant improvements in meeting the requirements of the Act. There continued
to be concerns of:
- inadequate input by health professionals
- inadequate preparation, orientation, ongoing education and support of caregivers
- inability to show adequate assessment, planning and delivery of care and support
- inability to evidence adequate and timely medical intervention, especially in emergencies
- inability to show a formalised quality and risk management system
- inability to evidence an operational infection control programme
It was recommended a second building, which the Ministry believed was substandard and unsuitable in its present state
for residential care, be closed down.
In addition to the ministry inspections, in December 2005, an audit of Culverden Group Ltd was carried out by designated
auditing agency, Bureau Veritas Quality International. Culverden Group Ltd had made application for new certification
because the trading name of the company had changed to Culverden Group Ltd, trading as Pasifika Centre and Hospital. The
audit stated that the intent of the applicable standards was being met but that several issues remained outstanding. A
renewal certificate was granted for only six months.
March 2006
On March 7 a temporary manager was appointed by the Ministry and Counties Manukau District Health Board to provide a
level of assurance about the quality of care residents were receiving.
Director General of Health, Dr Karen Poutasi, wrote to Culverden Group Ltd trading as Pasifika Centre and Hospital on
March 6 notifying the company of the Ministry's concerns.
Dr Poutasi notified the company she was considering cancelling the certification of Culverden Group Ltd, trading as
Pasifika Centre and Hospital, under the Health and Disability Services (Safety) Act 2001. Culverden Group Ltd was given
the opportunity to respond.
Culverden Group Ltd sought an extension to the timeframe in which to respond and this was granted by the Director
General.
Culverden Group Ltd sent a 48-page response. As a result, Dr Poutasi requested further information from Culverden and
the temporary manager.
Since then another onsite inspection has been completed. It was noted the temporary manager had remedied some issues but
the Ministry was not confident in the absence of a temporary manager that these changes would continue.
Culverden Group Ltd provided an action plan outlining how it planned to meet best practice standards.
* Why has the process taken 15 months?
The process the Ministry follows under the Health and Disability Services (Safety) Act 2001 is to encourage providers to
continuously improve the quality of the services they provide. As part of the principles of natural justice,
institutions are given time to work through improvements.
Following the December 2004 inspection, Culverden Group Ltd was required to provide the Ministry of Health with a plan
about how they would address the issues raised. Given there were a significant number of issues to work through
Culverden Group Ltd were given time to act on these.
After the June 2005 inspection the Ministry wanted to give the new management time to bring about the changes required
however it learned in January 2006 that the management had again changed and the previous management was in place.
A third inspection was carried out in February this year.
* Who are the residents of Culverden?
At the time of the inspection in February there were 106 residents at the centre and hospital. The majority of residents
were aged 65 and over. The bulk of these residents are funded by the Counties Manukau District Health Board. Some people
with disabilities are funded by the Ministry of Health's Disability Services Directorate.
ENDS