HSE-run care home criticised by inspectors

SEVERAL “unacceptable practices” have been uncovered by inspectors at a HSE-operated nursing home.

In their report on the operation of the 146-bed St Joseph’s Hospital in Ennis, Co Clare, Health Information and Quality Authority (HIQA) inspectors raised questions over the use of restraints, the safety of residents and the building itself.

Built on the site of a former workhouse in the 1960s, the inspectors state the HSE “was aware the building was structurally unsuitable and did not comply with legal requirements yet there was no plan in place to address these issues.”

The independent report found “the age, design and layout of the building presented many challenges in complying with the regulations and standards.

The inspectors noted inadequate day and dining space, institutional bedroom accommodation and a lack of private space for residents to meet visitors.

The report states: “There were inadequate sanitary facilities and residents did not have a choice of whether to take a shower or a bath as there was no bath.”

On the day of inspection, there were 124 residents at the hospital.

The inspectors reported the hospital was well organised and managed, with residents receiving a good standard of service, appropriate treatment and are treated with courtesy and respect.

However, they found “the provider failed to ensure the safety of residents by providing mandatory training to all staff members.”

Inspectors found many staff had not received training in the moving of residents since 2001, while the last recorded fire drill and evacuation was in 2008, with in excess of 50 staff not participating in recent fire safety training.

The inspectors also reported the person in charge stated the absence of funding had impacted on the provision of staff training.

The report goes on: “Restraint was not managed effectively to ensure the safety of residents. Inspectors noted that there was very little use of restraint, although some residents had bed rails in place.”

Furthermore, there was no risk assessment to ensure the safe use of the bed rails for each resident.

The inspectors also state the dining experience did not meet the needs of many residents, particularly those with high-support needs.

The staff were not knowledgeable about patients’ dietary requirements, stating that for example, an inspector observed a staff member giving sugary biscuits to a resident with diabetes.

The report states that in response, the HSE is putting in place a series of actions, including reducing bed numbers per ward from six to four to allow a separate dining room in each unit.

In its response, the HSE said that the hospital’s first inspection by HIQA “has been a significant learning experience”.

“We are committed to continuous quality improvement and will work with the inspectorate to ensure that the services which we provide are in accordance with the statutory regulations and best practice.”