A nursing home assisting people with dementia in Cobh, Co Cork, was dirty when inspectors from the States's health services watchdog paid a visit.
Inspectors from the Health Information and Quality Authority also found that the privately-run Cobh Community Hospital did not have the required garda vetting clearance for all personnel.
There were 43 residents in the centre at the time of the unannounced inspection last October and it was fully occupied.
Inspectors issued an urgent action plan to ensure all personnel in the centre were garda vetted.
It emerged that volunteers on work experience did not have garda vetting and did not have their role and responsibilities set out in writing.
Some of the volunteers did not have safeguarding training despite undertaking individualised activity sessions in residents' rooms on a weekly basis.
Inspectors also found that regular cleaning of the building was not taking place.
Bathrooms had not been cleaned adequately, with staining rust visible on toilets, sinks and paper towel dispensers. When foot pedal bins were removed, items such as tissue, disposable gloves, dust and other waste were found on the floor beneath.
Lack of access to shower had been a continuing issue for residents on the top floor of the main building, according to staff who spoke with inspectors. Until recently just one shower was available for 19 residents. Another shower had been broken for a long time.
It was further noted the senior management team was not always available and the provision of staff training was incomplete and inadequate. There were also fire concerns.
The provider has undertaken to address all the shortcomings outlined in the inspection report.
Meanwhile, an unannounced inspection last October of Midleton Community Hospital, Co Cork, a 53-bed nursing home run by the HSE, found serious management shortcomings.
Inspectors were told that senior HSE managers with responsibility for the centre did not visit it regularly or take a hands-on approach.
Despite a history of regulatory non-compliance and fire safety risks, local senior HSE management had not visited the centre since early last summer.
Those in charge of the centre that had 52 residents at the time of the inspectors' visit were in an acting capacity for a number of years so they did not have the authority to make the substantive culture change needed to bring the centre into compliance with the regulations.
The inspectors also found ineffective governance and management systems in relation to fire safety and among the issues, highlighted were inadequate staffing levels at night.
The fire risk had been identified by the HSE fire and safety officer but it was only when the Hiqa's chief inspector intervened that an additional staff member was put on duty.
Inspectors also noted none of the personnel records contained evidence of garda vetting disclosures. An urgent action plan was given to the provider and after getting an unsatisfactory response, the matter was addressed by senior HSE management.
The inspectors advised significant improvements were needed to enhance the quality of life of residents. As found during previous inspections most of the residents in the multi-occupancy rooms and bays, sat by their beds during the day and for meals.