Ensuring safe and lawful secure care placements

Some older people living with Dementia Mate Wareware (a Māori term for dementia) or other complex mental health conditions may no longer be safe in a standard residential care setting.They may be at risk of harm to themselves or others or may regularly attempt to leave care without understanding the risks.

In these situations, a secure care environment may be the safest and most appropriate option. Secure dementia or psychogeriatric care (secure care) provides 24/7 care and support in a setting designed to keep people safe while also protecting their dignity, health and wellbeing.

It allows staff to support and monitor residents closely, manage challenging behaviours safely, and provide specialised care in an environment that reduces risk.

Because this type of care involves restricting a person’s freedom of movement, the placement of a person in secure care requires an assessment to determine that the person needs secure care and a decision to place a person in secure care must be legally authorised. Ensuring each placement is lawful helps protect people’s rights while supporting their safety and quality of life.

Health New Zealand | Te Whatu Ora has developed guidance to support secure aged residential care providers know how to verify and record that each person has a valid legal basis for their placement in secure care.

The guidance follows recommendations from the former Chief Ombudsman, who found inconsistencies across the sector in how legal requirements for secure care placements are understood, applied, and documented. In some cases, people were placed in secure care without clear legal authority.

The guidance outlines the different legal processes that can authorise a person’s placement in secure care, such as activated enduring powers of attorney, welfare guardian orders, or personal court orders. It explains the requirements for documenting consent and maintaining up-to-date records. It also provides advice on what to do while legal orders are being processed.

While this document reflects current best practice and legal expectations, it is not formal policy and should not be relied on as a substitute for legal advice. Providers should seek legal advice if they are unsure about the legal basis for a placement.

Guidance for Aged Residential Care - Legal Authority for the Placement of People in Secure Care

We’ve also created a checklist that summarises the key requirements of the guidance. The checklist is intended to help providers confirm that each person in secure has the appropriate legal authority and that all necessary documentation is on file.

Checklist for when admitting a person to secure Dementia or Psychogeriatric care (secure care) in an Aged Residential Care (ARC) facility

Questions? Feel free to contact your local Health NZ contract relationship manager.