Concerns over staff and safety at nursing homes

The Health and Information Quality Authority has raised concerns over the safety, staffing, and management of medication at a number of nursing homes.

Hiqa yesterday published 23 inspection reports on residential settings for older people, 14 of which found serious major and moderate non-compliances.

The authority’s inspectors found the skill mix of staff at the Sacred Heart Residence in Raheny, Dublin, was not appropriate to meet residents’ needs. Inspectors also found that the system of supervision in place was not appropriate. Hiqa had previously received information in relation to residents “having to wait for considerable times before call bells were answered”. Inspectors also cited poor standards of clinical documentation, with a lack of records pertaining to the administration of medication to patients.

“A number of the prescription sheets did not indicate if the resident had allergies to any medicines or no know allergies,” inspectors noted.

The reports also raised concern over fire safety issues, such as fire doors and the condition of furniture in a designated smoking room: “The furniture within was largely upholstered and in some instances, the filling material was exposed due to the presence of holes in the cover material which is contrary to good practice in such rooms due to the potential flammability of filling material.”

Fire safety was also a concern at Shrewsbury House Nursing Home, Drumcondra. Its report said “adequate precautions against the risk of fire and safe evacuation of persons from all parts of the centre were not in place”.

“Means of escape was not fully maintained, and external lighting was insufficient at some fire exit points including the first floor exit,” the report found.

“External fire exits on the ground floor were uneven and not well lit at the time of the inspection. One double internal fire door beside the smoking room had a visible gap at the bottom of the door.”

Staff interviewed by inspectors “were not familiar with the evacuation procedures; including what actions to take in the event of a fire or evacuation”, it said.

A review of Kinsale Community Hospital raised concerns over the size of the residents’ rooms: “Not all of the four-bedded rooms were suitable in size to meet residents’ needs, and impacted on the privacy and dignity of the residents sharing these rooms,” the report stated, while inspectors also found that the 40-capacity hospital has a dining room that can only accommodate 15 at a time: “This provision of dining and sitting space was totally inadequate to meet the needs of the residents”.

“The inspectors noted visiting taking place in the four-bedded bedroom in the morning when residents were getting up and dressed, this practice did not protect the privacy and dignity of all residents in the room and other areas should be used,” it read, adding that residents on the first floor were “not provided with adequate sitting, recreational and dining space other than a resident’s private accommodation as required by the regulations.”

At the Retreat Nursing Home in Westmeath, the inspector found “that in the main, residents were not provided with opportunities to engage in meaningful and purposeful activities which suited their individuals’ needs and capacities”, and there “were periods during the inspection when the majority of residents in the sitting room were not supervised”.

• hiqa.ie