The Wellington coroner has criticised a halfway house, where a man was murdered in 2009, for understaffing and lax supervision.
Kelly Noema was stabbed at least 30 times by a fellow resident, Wiremu Haare, who is now serving life imprisonment.
Haare's murder trial last year heard how Mr Noema had become a nuisance to other residents of Mansfield House in Newtown, mainly because of his solvent abuse.
An audit of Mansfield House, which was home to about 20 residents, found it had only 2.7 full time equivalent staff.
The coroner Ian Smith says staff were unable to cope with the workload, and the trust running the house was inadequately supervised by Capital & Coast District Health Board.
Although staff numbers have now been increased to six, Mr Smith says the death again highlights the importance of DHBs doing proper checks on organisations they contract work to.
Manager of Mansfield House Carol Maruku says she feels the trust was let down by the DHB.