West Cork nursing home failed to tell watchdog of its existence

A West Cork nursing home that closed in the summer had failed to notify the Health Information and Quality Authority of its existence, it has emerged.

After becoming aware of Cara House in Skibbereen last year, the authority carried out advisory inspections, in Sept 2012 and Jan 2013.

Hiqa conducted a two-day registration inspection of the 20-year-old facility in April and it closed at the end of June.

The nursing home had 12 residents and was operating when legislation on the inspection and registration of designated centres for older people became law in Jul 2009.

Cara House, which was managed on a voluntary basis by Skibbereen Geriatric Society, failed to notify the authority within six months of the legislation coming into force.

Hiqa’s registration inspection report, published this week, details concerns about the level of dependency of a number of residents, medication management, and staffing.

It was found that one resident with a diagnosis of dementia, stroke, epilepsy, and a history of falls was assessed as low dependency.

At the time, there was no qualified nurse employed at the centre.

Inspectors found serious errors in medication prescription, and administration charts, and that care assistants were giving residents medications not prescribed by a GP. The home immediately addressed concern over the administration of medication by providing nursing cover.

Inspectors found that the size and layout of some bedrooms occupied by residents were unsuitable for their needs. Furniture had to be removed from the residents’ rooms before a hoist could be brought in.

Inspectors found there was no policy for the monitoring and documentation of nutritional intake. While food was served in sufficient quantities, it did not take into account residents’ likes and dislikes. One resident told an inspector that she often did not like what was served but that she had developed a taste for it over time. Inspectors found that residents’ privacy, dignity, and modesty was not respected at all times — residents were taken to the toilet via a public corridor in their nightwear and an inspector saw residents in a state of undress in their bedrooms because the door had been left open. Relatives spoke positively about the care their relative received but confirmed there was nowhere to meet in private other than the residents’ bedroom.

As the centre is now closed, the report does not include an action plan.

The society’s chairman, Martin O’Mahony, said it was decided to close the facility so as not to prolong the trauma caused to residents by ongoing uncertainty. The society said it would be impossible to upgrade the facilities, as demanded by Hiqa, mostly because of the physical space as well as expenses involved.