Donnybrook nursing home residents ‘not protected’ against abuse

Nursing home residents of the Royal Hospital Donnybrook are not being properly protected from abuse, according to a highly critical inspection report.

Some residents spend long periods in bed, or sitting by it, and not engaged in activity, inspectors from the Health Information and Quality Authority (Hiqa) found.

The report is critical of fire safety precautions and the standard of the premises, with inspectors noting “an odour of stagnant water” and “foul odours” in some rooms.

The report said residents who could get around independently were satisfied with the variety of activities available to them. “However, residents who did not enjoy the same level of independence were observed to spend the majority of their time in bed or by their bedside throughout the day with little interaction or stimulation.”

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Some residents who required assistance to move their wheelchairs reported hesitation in asking for help as they were concerned their request would inconvenience staff, according to the report. “One resident also described having to ask for this assistance on a daily basis just to be able to leave their multi-occupancy room to clear their head for 10 minutes.”

Another resident described how they “waited for Friday” when their boredom could be relieved by heading out and about with visitors, inspectors said.

The report said about half of the abuse incidents reported so far this year related to allegations arising from interactions between residents in multi-occupancy rooms. “Inspectors were not assured that reasonable measures were being taken by the provider to protect residents from abuse.”

Some residents said they dislike their multi-occupancy rooms. “The reasons given included feeling claustrophobic, not getting along with other occupants, lack of space for their belongings, and noise and disruption from the activities of other residents such as their snoring.”

These multi-occupancy bedrooms – which accommodate up to 48 residents in four- and five-bed rooms – were cluttered with belongings, limiting residents’ ability to store their possessions and enjoy privacy, and staff ability to clean spaces properly.

“Inspectors observed that the multi-occupancy rooms contributed to a culture of institutional care. Bedroom doors were left mostly open, including when residents were in bed or the room was vacant, and staff did not consistently knock or request entry at bedroom doors. En-suite facilities were used as storage space which impacted on residents’ ability to use them independently.”

Hiqa said the hospital has made “limited progress” on works needed to improve fire safety arrangements, mandated since a previous inspection in 2018.

“The inspection found that there was a lack of urgency and a fragmented approach at senior governance levels to address non-compliance and improve residents’ quality of life in the centre. There were insufficient measures in place to deal with issue of non-compliance the management team were aware of.”

Poor levels of cleanliness, hygiene, general maintenance and storage, as well as a lack of awareness of fire risks, were highlighted in the report.

Responding, hospital management said they recognised the inadequacy of the premises in relation to privacy and dignity. They promised to consult with residents about storage requirements and seek extra funding for improvements.