Two minute, 20 second mealtime in elderly centre - Hiqa report

Two centres for older people have been strongly criticised by the Health Information and Quality Authority (Hiqa) after a mealtime was found to be as short as two minutes and 20 seconds and a resident presented with signs of dehydration.

The report into the Adults Services Palmerstown Designated Centre 6, operated by Stewarts Care in Dublin 20, highlighted “significant concerns identified on both days of inspection resulted in two meetings with the provider and four immediate actions being issued”.

It found the centre had major non-compliances across all six standards reviewed, concluding the service was not safe and had failed to ensure residents were protected from abuse.

“One resident’s meal experience lasted a total of two minutes and 20 seconds,” it said.

“Residents who required assistance were not given this and inspectors observed a resident with a visual impairment was left unsupervised.

"It was evident from observations and from the assistive equipment used that this resident required assistance, however, the lack of supervision resulted in a significant portion of the resident’s meal falling on the floor and the resident eating some of their meal without cutlery.”

According to the report, inspectors identified a resident with specific hydration requirements was not being cared for appropriately and was presenting with symptoms of dehydration.

“Staff were not consistent with who was assigned to care for this resident.”

It also raised concerns over issues including peer-to-peer incidents of abuse, claiming in many cases they were not being adequately addressed by the provider.

Hiqa was also critical of the service provided at Adults Services Palmerstown Designated Centre 2, also operated by Stewarts Care Limited and home to 30 residents.

The inspection found major non-compliances in eight of the nine outcomes. It said residents were not supported with an acceptable standard of care and support, resulting in poor outcomes for residents, alongside evidence of institutional-type practices and care.

Overall, it said that the provider had failed in its requirement to provide a safe and appropriate service.

In finding that residents’ privacy and dignity was not upheld, inspectors observed a resident in one unit walk into the communal area from the bathroom on three occasions in a state of undress.

Regarding safeguarding and safety, “inspectors observed a number of residents were engaged in inappropriate sexualised behaviour in communal areas in one unit”, to which there was “a lack of response to protect both the residents engaged in the behaviour and peers in close proximity”.

In a second unit, there was no response by staff to attempt to support a number of residents, observed with exposed lower body parts.

Peer-to-peer incidents were not appropriately reported to the relevant personnel, and healthcare needs at the centre were also not met according to the report.

Hiqa said medication practices did not ensure residents were protected, including a reference to how one resident had not received medication as prescribed.

The report mentioned how one resident asked to go for a walk mid-morning but was requested to wait until staff breaks were over.

“Two hours later this resident had still not been brought for a walk and staff cited this was due to staff being too busy,” the report said. “During this period of two hours, the inspectors observed that for a period of time, three staff were engaged in sorting laundry.”