Residents at Waterford nursing home woken by staff at 6am

A nursing home has been strongly criticised after inspectors found some residents, who had been sedated the night before, were being woken up and dressed from as early as 6am.

The inspection, carried out by health watchdog Hiqa, found major non-compliance in four of the six categories reviewed at the Waterford Nursing Home on the Dunmore road.

The report, following the unannounced one day inspection, outlined how the Health Information and Quality Authority had received two separate concerns in relation to potential issues of safeguarding vulnerable adults in the centre.

The first concern related to an allegation of “institutional practice”, where residents were being washed and dressed before day staff began duty at 8am.

According to the report: “After inspectors arrived at the centre, by 6.05am, there were two residents awake and dressed and sitting in the dayroom, one resident upstairs, and the second resident downstairs. By 6.30am, two further residents were dressed and sitting in the dayroom, while a fifth resident was being washed and dressed at that time.”

That morning, inspectors observed that four residents who were up in the morning before 6.30am had received night sedation the previous night. “One resident had received two different types of psychotropic medication the previous night,” it said. “Inspectors saw that this resident was washed, dressed and sitting in the dayroom at 6.10am. Inspectors noted that a medication administration record indicated that a resident received a dose that was 50% higher than the dose clearly prescribed on the medication prescription sheet.

“Inspectors were not assured that nursing staff were administering medications from the prescription records as this error would not have occurred if nursing staff had administered medication from the prescription which clearly indicated that the medication dose had been altered.”

In response, management said that on the day of the inspection, two of those awoken early were heavily soiled and others elected to get up early.

The second concern Hiqa had received prior to the visit related to the removal of a call bell — an alarm system so that a resident can get immediate attention if needed — from a resident at night.

“The person in charge outlined to inspectors that he had been made aware of a complaint regarding an allegation of neglect of a resident. Inspectors spoke to staff regarding this allegation of neglect. The person in charge said that he was to conduct an investigation into this allegation which he was to forward to the authority.”

The report added that “the issue of staff unplugging call bells in an unauthorised manner had not been adequately investigated”.

There was evidence that an allegation of abuse of a resident on August 29 last had been verbally reported by staff to the assistant director of nursing on the morning after the incident. However, Hiqa only received a notification from the person in charge on October 30.

A separate Hiqa report found inadequate staffing levels at Dungarvan Community Hospital.