During this time one community support worker, Mr C, pushed Mr A's hand to his mouth when he did not cover it while coughing. When Mr A tried to pull his hand away, Mr C pulled him of his chair and pushed him into his room for time out.
The incident was not reported, and a fellow care worker, Ms E, who witnessed the incident also failed to report it.
Mr A's mother told the commission that, following the incident, her son often mentioned Mr C's name and said that he did not want to return to the facility. On other occasions a support worker, Ms D, did not give him his medication.
In his ruling Mr Hill said the facility had failed Mr A in a number of areas, including staff training and medication management.
He recommended the facility and the two care workers make written apologies to the young man and his family.
Mr Hill also said that while the care home had made a number of changes to improve staff training, that it should take additional steps to improve the services it provides to its clients.
NZCare Group director Peter Hausmann said he accepted the findings.
"We have apologised to the client and his family for the substandard support received at our respite service," he said.
"The safety and wellbeing of the people we support is paramount and in this circumstance we did not deliver the standard of support the client or family should expect.
"We take the issues raised in this complaint very seriously and have taken immediate and appropriate action."
He said the company takes responsibility for what happened and is "very sorry for any distress" Mr A and his family experienced.