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THE LATEST INSPECTION reports by the Health Information and Quality Authority (HIQA) found non compliances in a number of nursing homes.
Since the last inspection, an allegation of abuse had been made at St Colmcille’s Nursing Home in County Meath. HIQA enquired with the nurse in charge and, following a review of available records, the allegation (which was made previously in June 2014) was confirmed.
However, HIQA had not been notified as required under the regulations, finding the nursing home moderately non-compliant.
Allegation of abuse
On further examination, the inspector found that staff had not recognised this matter as
an allegation of abuse and had not implemented the policy in response to allegations of
abuse.
The allegation had not been sufficiently investigated, documented or reported in
accordance with best practice guidelines in order to safeguard residents, said HIQA.
The inspector requested that the nurse in charge take appropriate action to address the allegation made.
In addition, since the last inspection one resident required hospitalisation as a result of being given an incorrect textured food by a staff member that contradicted specialist recommendations.
“While the matter had been responded to in a timely manner and the resident had recovered, the incident was preventable,” states the report.
A number of hazards that posed a risk to residents’ care and welfare were also discovered.
Transported on commodes
The report finds that one resident was seen being transported from his bedroom to the bathroom on a commode in the company of two care staff.
It was confirmed with staff that this resident’s privacy and dignity was not adequately maintained as he was not fully or appropriately dressed while seated on a commode in a public area.
The inspector requested to cease and review this practice immediately. Staff also confirmed that residents were showered while sitting on commodes.
There was also an unexplained absence of one resident which occurred since the last inspection, however, a missing person drill had not been practised since to inform staff in the event of re-occurrence.
The report also finds that a number of the wheelchairs and equipment were rusted.
Many of the other areas in which the nursing home were inspected were deemed as compliant or were only minor faults.
St. Joseph’s Centre in Shankill in Dublin was also found to be non-compliant in some areas. The inspectors were concerned that residents healthcare needs were not met in a timely manner to ensure early detection or intervention to prevent ill health and care.
Fall reports
Records for 2014 showed that a number of residents had repeatedly fallen over,
with some resulting in serious injuries. However, records did not show that
appropriate care was provided for all residents following a fall.
In one case, appropriate and timely emergency care was not provided to one resident following a fall.
The report also found that one resident had extensive bruising on their forehead, although there was no evidence of an investigation into the cause or actions taken in response to the incident in July 2014.
The system in place to monitor residents’ nutritional needs and weight required improvement, as did the meal time practice.
It was discovered that one resident had experienced significant weight loss yet there was no plan to manage this residents’ needs. There were no care plans in place to address identified weight loss.
‘Meal time an uncomfortable and unsociable experience’
Meal time was something that was very concerning to inspectors, who said that it was not provided in a discreet or a sensitive manner that enabled residents to eat and drink.
“The mealtime was a delayed, uncomfortable and unsociable experience for residents at times,” states the report, adding that one unit residents had to wait up to one hour for their meal to be served, and some appeared to be hungry.
“One resident leaned across another resident and started taking food off their plate. This food was not a consistency suitable to the residents assessed needs and put the resident at risk of chocking. Inspectors intervened at this point and brought the matter to staff attention.”
The report finds that the residents were not consistently assisted by staff to eat their meal and during mealtime a number of residents were observed sitting alone with food on their face and clothing.
The inspectors were concerned that one resident had food on their face,
and had still not been addressed after inspectors had left and returned to the dining
room a short time later. Some residents were also left to sit at the dining table long after
their meal had been eaten.
They were so concerned about meals and the mealtime experience they reported their concerns and also spoke to the person in charge during the inspection.
Appropriate action was found to have been taken in response to inspectors comments.
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Staff in NH and hospitals are no longer doing traditional nursing. They are meeting all of HiQA requirements alright , ticking boxes , filling forms. Meantime they don’t have time to care for the patient. Give me a nurse who will care any day of the week ..but they have been strangled by bureaucracy and paperwork. I’d rather see a rusty wheelchair with a happy patient in it than a shiny one with a patient left alone while a nurse fills out forms about them. HiQA has become like the Spanish Inquisition. W have lost something while endeavouring to be correct about everything.
Well said Helen. You hit the nail on the head.In HIQUAs eyes its paperwork and box ticking over real nursing care.
Absolutely right Helen. Hiqa focuses on it’s paper standards not the quality of actual care. Nursing staff have to spend their time filling out forms and covering ass from hiqa. Gone are the days of real care when buses could chat to patients check how they were feeling mentally and physically and care for the whole person. The hiqa standards are so extensive no unit will be fully compliant. I have yet to read a report where all standards had been reach there is always some nit picking. That way they create a job for themselves. In a time of public service employment and cut backs this quango has grown greatly. Money that could have been spent in service provision. It
All we hear about are the bad nursing homes
There are some wonderful nursing homes and my mother is in one of these
The Tara in bray
It is home form home and the staff are caring ,loving and go the full mile
All presided over by the wonderful owner anne Costello
Let’s hear a bit more positive reports
Otherwise people get scared
^^^There is a plug form an nursing home owner if I ever saw one……
But the message in the post is correct. There are allot of really good Nursing Homes out there. Unfortunately we only hear the horror stories.
Also instead of putting all the blame on the Director of Nursing/Matron(as HIQUA seem to do) the nursing home owners must be held accountable also.
@Phyllis
Care staff are not allowed to ‘care’ as they would
like to as they have targets,paperwork,no beds and middle
managers to deal with.Nobody goes into nursing wanting to
take patients around a hospital on commodes.
My grandad has been in a nursing home for almost 2 years due to Alzheimers it would be impossible to care for him at home. The work the nurses and carers do is truly commendable, due to budget cuts and pencil pushers demanding paperwork etc. it is impossible for the staff to care for each individual patient that the way they would want to and should be cared for!
I visit my grandad twice a week both times when he’s getting one of his meals, the staff are running back and forth trying to make sure each patient has a meal, there are 12 patients in my grandfathers ward that can’t feed themselves my grandad included there will be max 2 nurses on duty and 3-4 carers, they are doing their best in stretched situations.
Reports like this annoy me, they cost money and don’t help anyone, often make it appear that residential staff don’t care and fail to help anyone!
Those pen pushers and whoever makes the decisions to cut back would want to realise if they are lucky to reach old age that’s what’s ahead for them.
@Row-Sheen: So what are we to do? Are you suggesting we should ignore reports of elder abuse? Really? What if it were you being wheeled around with your underwear down? Just because you have had a good experience does not mean that others have had and it is critical to highlight incidences of this nature so as to acknowledge that they are unacceptable.
What has happened to ‘care staff’ that allows them to treat their patients in this awful manner :(
Places don’t have enough staff too manage?
Few years in a nursing home costs hundreds of thousands of Euro and the state pays for it. The more old people the greater the strain on the system.
What do you suggest then, euthanasia? No matter what the cost to the state for their accommodation, the cost of preserving their dignity is zero. These are the people who gave us the state to begin with.
@David Burke the HSE nursing homes are understaffed, too much emphasis on forms and bureaucratic nonsense which results in time taken from the nurses in providing care to the residents.
With regard to payment I am afraid that you are incorrect in assuming that the state picks up the tab. The HSE will recoup as much as they can from the patient. After assessment the HSE will take 80℅ of the weekly pension plus 7.5℅ per annum of any assets held. You are allowed to keep the first €36,000. The HSE will then provide a loan to cover the balance which is recouped upon your death.
Eg: savings €36,000 (not counted)
Value of assets €100,000
Pension €248 pw
248 x 80% = 198.40
100,000 x 7.5℅ = 7500/12 = 625
625 + 198.40 = a weekly contribution of €823.40
I know this as I was in the unenviable position of contemplating this type of care for my terminally ill mother. I have since decided to care for her at home under the palliative care system.
http://www.hse.ie/eng/services/list/4/olderpeople/nhss/nhss.html#fin
Yet another appalling indictment of the treatment of the most vulnerable. Will anybody be held to account for this? I very much doubt it.
I think the nurse in question will…
These problems and issues are a direct result of cuts and staff shortages. Before the recession, on a 31 patient ward, there were 4 staff nurses and 2 care assistants. Now there are 2 staff nurses and 1 care assistant. How are they expected to feed the dependant patients at meal times AND do the drug round at the same time when there is no staff. Nurses are doing their best and all they receive from from HIQA is criticism instead of a ‘we know you’re stretched to the limits but we know you’re doing the best you can’.
The drive to the bottom for costs is behind this. Owners have to absorb increasing costs to maintain their profit levels and think they can do so by cutting staff costs. A real acandal is the homecare system where staff t&c’s are being hacked to boost profits while taking in donations of food from multi national shops that are wholly unsuitable for their clients. Anything to save another euro by those on already bloated, unjustified salaries
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