The Health Information and Quality Authority received information about the incidents after a resident was found to have unexplained bruising in May last year. Before making the unannounced inspection of the HSE-run facility last October, the authority had asked the hospital to investigate the allegations and provide it with a report.
The hospital was unaware of the first incident that occurred in September 2014 but knew about the second one which occurred last July. It initiated a disciplinary process in relation to first incident that was ongoing at the time of the inspection but found that the second one was unsubstantiated.
Hiqa found the investigation of the second incident was not enough to support the findings and issued management with a warning letter outlining its concern. However, a further more comprehensive investigation also found that the allegation was unsubstantiated. An earlier investigation of the bruising found it might been caused by staff reaching out to a resident in danger of falling.
Overall, inspectors found that progress had been made in relation to safeguarding practices. They found that a protocol for managing unexplained bruising had been developed and, while not yet implemented, records indicated that staff had increased awareness of bruising as a potential sign of abuse, and all incidents of bruising were investigated.
Earlier this year it was announced that the hospital is to be redeveloped at a cost of €16m under the Government’s 2016 to 2021 capital plan. Hiqa found that the five units within large institutional-type buildings which accommodate 89 residents in multi-occupancy bedrooms were unsuitable. The HSE intends building a new 100-bed community nursing unit in the ground of the current hospital. Minister of State for mental Health and Older People, Kathleen Lynch, said while staff provided an excellent service, the buildings were not fit for purpose.
There was an unannounced inspection of St Joseph’s Nursing Home, Kenmare, Co Kerry, last October after the authority was alerted to “practices” that might have violated the personal integrity of some of its 49 residents. The practices that were not specified related to care needs. They were undertaken without the consent of the residents — a number of whom had dementia. The inspectors found evidence that the practices were taken place in the family-run home.
Emer Kidney, an experienced nurse manager, who is involved in the day-to-day organisation and management of the service, told the inspectors the practices would be discontinued immediately .
While there was a record of all incidents and accidents maintained at the centre, inspectors found that the authority had not been notified about a serious incident that required hospitalisation. The authority also found it was not notified about an abuse allegation, the sudden death of a resident, and residents who developed pressure sores.
Ms Kidney said there was an allegation of peer abuse between two staff members and it was being investigated. She said a resident who had been acutely unwell had passed away in his sleep.
The inspector also found Ms Kidney failed to notify Hiqa when restraints — lap belts or bedrails — were used.