Hiqa critical of HSE-run nursing home

INDEPENDENT INSPECTORS have uncovered several “unacceptable practices” at a Health Service Executive (HSE)-operated nursing home in Ennis.

In its report on the operation of the 146-bed St Joseph’s Hospital, Health Information and Quality Authority (Hiqa) inspectors made negative findings in relation to the use of restraints, the safety of residents and the building itself.

Built in the 1960s on a former workhouse site, the inspectors say the HSE “was aware that the building was structurally unsuitable and did not comply with legal requirements, yet there was no plan in place to address these issues”.

The report says “the age, design and layout of the building presented many challenges in complying with the regulations and standards. Inspectors noted inadequate day and dining space, institutional bedroom accommodation and a lack of private space for residents to meet visitors.”

It continues: “There were inadequate sanitary facilities and residents did not have a choice of whether to take a shower or a bath as there was no bath”.

On the day of inspection, there were 124 residents at the hospital.

The inspectors say the hospital was well organised and managed. Residents received a good standard of service, appropriate treatment and were treated with courtesy and respect. However, “the provider failed to ensure the safety of residents by providing mandatory training to all staff members”.

Many staff had not received training in moving residents since 2001; the last recorded fire drill and evacuation was in 2008 with more than 50 staff not participating in recent fire safety training.

The person in charge stated that the absence of funding had affected the provision of required training for staff.

The report goes on: “Restraint was not managed effectively to ensure the safety of residents.” There was very little use of restraint, although some bed rails were in place. The report says there was no risk assessment to ensure the safe use of the bed rails for each resident.

The dining experience did not meet the needs of many residents, particularly those with high support needs. Staff were not knowledgeable about patients’ dietary requirements – for example, an inspector observed a staff member giving sugary biscuits to a resident with diabetes.

Hiqa says the HSE is putting in place a series of actions to deal with the report’s findings. The HSE says the hospital’s first inspection by Hiqa “has been a significant learning experience”.