Resident absences cause for concern at HSE nursing units

AN INSPECTION of Health Service Executive-run nursing units in Dublin’s Phoenix Park has found a large number of unexplained absences of residents from their wards.

Inspectors from the Health Information and Quality Authority (Hiqa) also uncovered significant levels of abuse and mistreatment of residents by other residents at the nursing home units in the former St Mary’s Hospital.

During an inspection carried out in November and December 2011, they also noted a significant number of complaints regarding agency staff, including medication administration errors, allegations of abuse and questions over their competence relating to poor communication and attitude towards residents.

Some 39 residents were logged as absent without leave in a seven-month period, according to the report. However, only nine unexplained absences had been reported to the authority in the previous year, as required by the regulations.

Residents had made their way out of the ward area and were detected and found by hospital staff from other wards or departments. Of the nine reported incidents, seven involved patients being found outside in the grounds of the park.Despite concerns being raised, incidents of unexplained absence recurred, the report said.

Inspectors also found evidence of practices that exposed residents to cross-infection. Open waste bins were found outside an open doorway to the kitchen, rubbish was left lying along corridors, a rat was seen in the activity garden and birds were flying in and out of open windows above the catering area.

The report also criticised the “fragmented” auditing system in place. Incidents such as weight loss, complaints, unexplained absences, missing records and altercations between residents were not dealt with to bring about improvements. Incidents were not being consistently reported to the person in charge or acted upon. As a result, a breakdown and delay in communicating significant events to management was apparent.

St Mary’s Hospital, which houses 188 residents, did not have a secure or appropriate environment to maintain the safety and welfare of cognitively impaired mobile residents, according to the report.

However, a further inspection carried out last March and April found considerable improvements in the running of the home. Measures to protect residents from forms of abuse and harm had been improved and put in place, the authority said. A significant reduction in unexplained absences was noted in the preceding two months. Learning from incidents and experiences had brought about improvements in management and clinical governance, it said.