Hiqa urges action on care abuse allegations

Health watchdog Hiqa has raised concerns over how allegations of abuse at a nursing home were managed.

In an inspection report on the HSE-run St Finbarr’s Hospital, the Health Information and Quality Authority (Hiqa) said it was not satisfied that an allegation of potential abuse had been adequately investigated prior to it being brought to their attention by a relative.

The hospital, located in Cork City, was home to 89 residents at the time of the two-day inspection last May. The report stressed numerous areas of good practice, said the centre was adequately resourced, and stated that the overall feedback from residents and family members interviewed was “complimentary of the care provided”.

However, it said: “Significant improvements were required, most notably in safeguarding practices and in the design and layout of the premises.”

More pressingly, the report also raised issues over bruising sustained by a resident and how the matter had been dealt with.

“The record of one resident identified that the resident presented with bruising of unidentified origin, however, records were not available to indicate that this was appropriately investigated prior to a complaint from a relative,” said the report.

“A notification of an allegation of abuse had been submitted to the authority as required by the regulations prior to this inspection. The allegation related to unexplained bruising on a resident.”

A subsequent investigation concluded that the bruising may have been as a result of staff members assisting the resident to the ground to protect the resident from injury due to a near fall event.

“Even though staff members spoken with by inspectors were knowledgeable of what to do in the event of suspicions or allegations of abuse, based on a review of the resident’s records, inspectors were not satisfied that staff demonstrated adequate awareness or responded appropriately to possible signs of abuse by not investigating unexplained bruising prior to it being brought to their attention by a relative,” said the report. “Based on a review by inspectors of the report of the investigation into the allegation, inspectors were not satisfied that the investigation was sufficiently wide-ranging to incorporate all incidents of unexplained bruising.”

The report said another allegation of abuse was made to inspectors during the visit, relating to how a staff member interacted with a resident. Hiqa asked that an investigation be conducted.

In its response, the hospital’s management said all staff have received training in elder abuse and that training is ongoing.

As for the primary allegation, it said: “A review of the resident’s medical and nursing notes took place to identify the cause of bruising. A full medical review was completed and all staff members were interviewed. The review identified that the resident was a high risk for falls and it was determined that the bruising may have been as a result of staff members assisting the resident to the ground to protect the resident from injury due to a near fall event.”

It added that the hospital has secured the placement of an independent advocate.

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