Hiqa: Privacy and dignity of patients compromised

An inspection of Kanturk Community Hospital by the health watchdog found while the standard of care was good, the layout of the premises compromised the privacy and dignity of residents.

The problem with layout related largely to the bedrooms, some of which were shared by multiple residents, where beds were in close proximity. Inspectors from the Health Information and Quality Authority (Hiqa) said some bedrooms were used “as thoroughfares to access other bedrooms” posing “significant challenges to staff to respect the privacy of residents and provide care in a dignified and respectful manner”.

The 40-bed Health Service Executive facility was described as “bright, clean and in a good state of repair” but there was no safe outdoor space for residents because an area with garden furniture was located beside the entrance driveway and was not secure, inspectors said.

They were also unhappy with what they described as “inadequate communal facilities”, too small to accommodate all residents simultaneously. Inspectors were critical of a dearth of wardrobes for personal clothing and the location of TVs in some bedrooms where residents couldn’t see them.

Another area of major concern was the absence of a plan for responding to emergencies and “insufficient evidence that the risk management policy was fully implemented in practice”.

A number of doors were found to be “repeatedly left unlocked to areas that could pose a risk to residents, such as the sluice room and the housekeeping room where residents with a cognitive impairment could have access to unsafe materials”.

There was no system in place to verify that electronic door locks were functioning and one of these doors was found to be non-functioning on day two of inspection.

There were three sluice rooms, but not all had hand- washing facilities.

In its response to the Hiqa report, the HSE outlined remedial action it proposed to take to address the various shortcomings. However, inspectors said some fell short of what was required and warned they were considering “further regulatory action” in relation to certain issues, particularly the problems of layout.

The announced inspection was carried out in February.

An announced inspection of Caherciveen Community Hospital last January found care at the 33-bed facility was of a good standard but that some improvements were required, “notably” to design and layout because of inadequate communal space and inadequate external secure space for residents.

While the HSE proposed certain remedial action, Hiqa concluded it did not adequately address the failings identified and chose not to publish the HSE response, again warning of “further regulatory action”.

However, there were no areas of major non-compliance at the Caherciveen facility.