Fire safety and governance issues identified by Hiqa in nursing homes

Almost half of the nursing homes that were subject of the latest batch of inspections by the Health Information and Quality Authority (Hiqa) were found to be non-compliant with regulations.

Of 29 inspection reports released by the health watchdog on Tuesday, 14 contain evidence of non-compliance with fire precautions, proper governance and other issues.

At Hollybrook Lodge, a nursing home run by St James’s Hospital at St Michael’s Estate in Inchicore, Dublin, inspectors said it was not clear if sufficient resources were in place to meet residents’ recreational needs.

“Inspectors were told that up to 90 per cent of the residents on site had dementia or a similar cognitive impairment, and many were observed throughout the day not engaged in any meaningful activity,” Hiqa said.

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It also found evidence of insufficient resources being provided to maintain the building, that some governance policies were out of date and that personnel and Garda vetting records were not maintained on site. Inspectors also identified gaps in staff training, and delays in addressing maintenance issues.

Hiqa noted that staff routinely referred to residents as patients, and also raised other issues more akin to hospital practice than a nursing home environment. These included residents remaining in bed until noon, and residents being placed in the dining area up to 50 minutes before meals were served.

Wedged open

The centre was non-compliant on fire regulations as 29 staff had not received training and some doors were found to be wedged open on the day of inspection.

At the Powdermill nursing home in Ballincollig, Co Cork, inspectors found the provider was not taking adequate precautions against the risk of fire in relation to the storage of oxygen cylinders, the evacuation of residents with limited mobility and the standard of the fire detection and alarm system.

The report was critical of evacuation arrangements for residents on the first floor in the event of a fire, and said improvement to fire checks were needed.

With most residents eating their meals in their bedrooms, the report says their experience could be enhanced by providing more suitable seating arrangements.

At Rivervale nursing home in Nenagh, Co Tipperary, inspectors found many rooms in the building, as well as equipment and furniture, were not clean and not in a good state of repair.

They found staining on walls, dust and cobwebs on walls, ceilings and behind furniture, and armchairs with damaged upholstery.

“This impacted upon the pleasant appearance of the centre, as well as affecting the ability of some surfaces and items to be cleaned effectively in line with good practice standards for the prevention and control of healthcare-associated infections,” the inspection report noted.