Residential care covers four levels: rest home care, age-related hospital care, dementia care, and psychogeriatric care. People who receive this level of care cannot live independently and need assistance in daily living. In some retirement villages, you may be able to move into residential care from your independent living arrangement within the retirement village if your needs change.
Needs Assessments
If you think you need residential care, you should have your needs assessed by a Needs Assessment Service Coordination (NASC) service. This service reviews your abilities and needs to see what level of help you may need. You can read more about Needs Assessments on our page here. A Needs Assessment will be necessary to apply for any government subsidy for residential care.
Paying for care
Residential care in New Zealand may be subsidised by the government or paid privately. There are limits on the maximum amount that can be charged for the necessities of residential care that are outlined by the government.
Residential Care Subsidy
Depending on your assets and income, you may be eligible to receive a subsidy for your care. The subsidy will pay for most of the cost of your care if you qualify, and your income will pay for the rest. If you do not meet the eligibility criteria, you will have to pay for your care by yourself. You can ask for a review of your means test at any time if you think that your eligibility may have changed. You can read more about the asset and income thresholds for eligibility at Work and Income.
Residential Care Loan
If you are above the threshold for the Residential Care Subsidy, you may be able to apply for the Residential Care Loan. This loan is primarily for people who own the house they lived in before entering residential care. This loan is interest-free and must pay for your residential care. When you die or your house is sold, the loan is paid back to the government. You can read more about the Residential Care Loan on the Ministry of Health website.
Maximum contribution
If you are assessed as needing residential care through NASC, the residential care provider is limited to a maximum weekly sum that they can charge you for services. This limit, called maximum contribution, varies based on region. You can find the maximum contribution for residential care in your area here. This may be covered by the Residential Care Subsidy if you are eligible, or you may need to pay for it privately.
Maximum contribution covers the basic needs of residential care, regardless of the level of care received. Services and care that must be covered by the maximum contribution includes:
- Accommodation, including amenities such as bathrooms
- Food services
- Laundry
- General equipment for mobility and personal care
- Nursing care
- GP visits
- Prescribed medications and all healthcare that is prescribed by a GP
- Continence products
- Diversional activity
You may also be offered extra services that are paid for on top of the maximum contribution. These services are not compulsory and must be itemised in your admission agreement. Extra services may include:
- Specialist visits that are not publicly funded
- Transport to services that are not health related
- Private toll calls
- Personal phones and internet access
- Newspapers, books, and magazines
- Insurance for personal belongings
- Personal clothing, footwear, and toiletries
- Recreational activities that are not part of the normal programme
- Hairdressers
- Dieticians, podiatrists, and other services that are not prescribed by a doctor or DHB funded
- Glasses, hearing aids, and dental care
To understand more about the maximum contribution, check the Ministry of Health website.
Documentation and agreements for care
Moving into residential care will include signing an admission agreement, creating a care plan, and may also include assigning an Enduring Power of Attorney (EPA).
Admission agreements
This agreement is a contract signed by you and the residential care provider to outline what will be provided and what your responsibilities are. This contract should also include any extra services you have agreed to receive. You can refuse any of these extra services if you do not want to pay for them.
Your agreement should outline information including:
- The cost for your care
- Who is paying and how payments are made
- What services are included in your weekly payments and what you will pay extra for
- What happens if your personal belongings are damaged or lost (money and valuables are your responsibility)
- The arrangements for your safety and security
- How much notice you have to give if you want to transfer or leave
- The staffing arrangements in your residential care facility
The agreement should also have the code of residents’ rights, which outlines the rules for the residential care facility and how to raise complaints. You may get legal advice on your admission agreement before signing it.
Care plans
A care plan is an ongoing document that outlines your needs. It is personalised to suit you. It should include information on your medical needs, your diet, when and how to contact family if your health changes, and other information that may be important for your wellbeing. Care plans should be based on your strengths, values, goals, choices, and lifestyle wishes, including cultural and spiritual needs. Care plans are usually reviewed every six months or earlier if necessary. If you can no longer contribute to your own care plan, your family or EPA may be asked. You can find out more about care planning at Health Navigator.
Enduring Power of Attorney
Some residential care providers may ask you to set up an Enduring Power of Attorney (EPA), who will be responsible for making choices about your personal care and welfare, your property, or both. The EPA will make decisions for you if you can no longer make or communicate your own decisions. Your EPA should be someone you trust to make decisions that are in your best interest. You can read more about EPAs on our page here.
How is residential care quality monitored?
Residential care providers can become certified by the Ministry of Health. Certifications are completed by audit every 1-4 years depending on how well the provider has performed on previous audits. Another unannounced spot audit occurs in the middle of the certification period. These audits look at the way residents are cared for, the general environment, how staff interact with residents, and the clinical records, policies, and procedures of the provider. This may include interviewing staff, residents, and family members to understand how they find the quality of care.
If a serious complaint is placed, the Ministry may inspect the provider under the Health and Disability Services (Safety) Act 2001. You can find out more information about certifications and Ministry inspections, as well as view audit reports from prospective care providers on the Ministry of Health website.
Complaints
If you have a complaint about your residential care provider, you should first approach the provider to let them know. You are allowed to have a support person or advocate with you when making a complaint. This can be a friend, family member, or supporter from an advocacy agency. If the issue cannot be resolved this way, there are other options to resolve the issue. You can:
Finding residential care
You can contact your local Age Concern, DHB, or NASC agency for a list of residential care providers in your area. You can also find a directory of residential care providers on Eldernet and at Find a Rest Home.
Websites of interest
- Eldernet created a checklist for choosing a residential care provider
- You can find more information about long-term residential care on the Ministry of Health website
- The Where From Here book provides information on services for older people, including residential care
- Alzheimer’s New Zealand has made a booklet about transitioning into residential care for people with dementia