Watchdog extends care home ban

A temporary ban on accepting new residents at a Cork nursing home has been extended following an inspection by the health watchdog.

When inspectors from the Health Information and Quality Authority (Hiqa) arrived at Rochestown Nursing Home, Monastery Rd, Cork, at 11am on October 17 last, they found it without electricity since 1pm the previous day on account of a power cut caused by extreme weather conditions.

The nursing home provider did not have a generator to maintain essential services and had not tried to source one by the time the unannounced inspection began. Inspectors said that during the power outage there was no heating in the centre and no lights “with the exception of tea lights and torches”. Residents had to use the bathroom and get dressed for bed with only the use of a torch. Call bells were not working and inspectors saw numerous fire doors “wedged open with wedges, blankets and other items as the hold-back mechanisms were not working”.

Residents’ essential equipment such as pressure-relieving mattresses and nebulisers were not working. However arrangements were in place to reposition residents more frequently. Magnetic doors were not locked and exits were not alarmed. Inspectors said that this “increased the risk of absconsion by residents”.

Inspectors “insisted” that a generator was required to maintain essential services and it was “eventually sourced and was about to be installed when the power was returned at 7.45pm”.

Inspectors said there was “a risk to residents” during the outage. On a positive note, staff had started a sing-song during the power cut which most residents took part in. A gas hob meant hot food and drinks were available. Inspectors found that residents’ overall healthcare needs were met and that they appeared to be very well cared for.

They were consulted about the running of the centre and feedback was sought to inform practice. They could voice concerns at residents’ meetings. Inspectors said: “The feedback from residents and relatives was generally positive”.

It was Hiqa’s eighth inspection of the home, which can cater for 22 residents, and inspectors said it had a “history of non-compliance” which was ongoing, leading to Hiqa attaching restrictions to the centre’s registration in June 2017, including that no new residents be admitted. During a July inspection, Hiqa found this condition had been breached. The restriction was kept in place following the October inspection, though improvements had taken place including the hiring of a new governance manager and a new person-in-charge.

However, inspectors’ remained concerned about gaps in staff vetting, incomplete staff files, and one member of staff in a senior position was without any staff file. They were also concerned about a lack of emergency planning, and inspectors said recruitment practices continued to be unsafe, such as failure to secure references.

Hiqa had highlighted in its July inspection report that staffing levels required review. Inspectors noted that “under current conditions, staff found it difficult to perform all assigned tasks, particularly around lunchtime and in the evenings when residents required assistance to go to bed”.

Concern was also raised over the number of staff working in the centre on a part-time basis with full-time jobs elsewhere.

Responding to Hiqa, the provider outlined a number of actions they were taking, designed to meet the standards of care, including a review of staffing levels in relation to assessed needs of patients by the person in charge; having a power generator available going forward in the event of an emergency; auditing and secure storage of staff files.