Daily life for residents at a HSE-run hospital was "dictated by unconscious institutional practices", illustrated by how one woman's request to sit outside in the sun couldn't be facilitated and she was instead brought back to sit by her bed.
An inspection report published by HIQA into Kanturk Community Hospital in north County Cork found it was non-compliant with 12 of the 17 regulations assessed, with the health watchdog concluding that: "the registered provider had failed to ensure that an effective and safe service was provided for residents."
There were 40 residents, mainly aged over 65, at the time of the July inspection by the Health Information and Quality Authority, and while their feedback was generally positive about staff, inspectors found numerous shortcomings, including that there was "very little opportunity for autonomy and personal choice" for residents.
"On the day of the inspection, a beautiful summer’s day, one resident’s request to sit outside in the sun was not facilitated," it said. "Instead that resident was brought back to sit beside her bed after lunch where she would be safe, sitting in a very small confined space looking at another resident in the bed across from her. This was in spite of the fact that there was a lovely sheltered and protected outdoor space available that allowed residents to watch passers-by and interact with acquaintances accessing other services on this campus. However, no staff were allocated to the outdoor area to support residents to avail of it."
Staff explained the resident could only avail of this resource when relatives were available to accompany her so she didn’t fall. Several residents did use the area during the day of the inspection but at least five residents seated in the sun room said while they would like to use the outside area, they did not think that they could.
HIQA found that the service provided met the needs of the residents, particularly in terms of fire-safety, infection control, staffing, access to meaningful recreation and activities, personal accommodation and storage. Long-term residents continued to be accommodated in multi-occupancy rooms for up to nine people.
Interim governance and management arrangements in place did not empower local managers with the necessary authority to effect the substantive cultural change required in the centre, while the HSE had not formally appointed a director of nursing, which had been vacant for more than a year. Recording of information for notification on a quarterly basis was incomplete, while four personnel records reviewed did not contain An Garda Síochána vetting disclosures in accordance with the National Vetting Bureau (Children and Vulnerable Persons) Act 2012.
"In conclusion the findings of this inspection were that significant action was required on the part of the registered provider to ensure improved regulatory compliance and the provision of a safe and effective service for residents.
In response, the GHSE outlined the measures it would take to remedy the shortcomings identified in the report, but in seven instances HIQA responded that "this compliance plan response from the registered provider did not adequately assure the office of the chief inspector that the actions will result in compliance with the regulation" - prompting a revised response from the HSE.