CONCERNS HAVE been raised over staffing levels at two large nursing homes – one in Co Leitrim and another in Co Clare – and at a smaller facility in Monaghan by the Health Information and Quality Authority (Hiqa) following inspections of the facilities.
When inspectors visited the HSE-run St Patrick’s Community Hospital in Carrick-on-Shannon, Co Leitrim, they found there were only two members of staff on night duty in a unit accommodating 36 male and female residents, all of whom had high or maximum dependency levels.
This unit was on the first floor of the hospital and, given its low staffing levels between 6.30pm and 8am, inspectors were concerned about how residents might be evacuated in the event of a fire.
In addition, they said there was no person in charge of the centre at night “to make decisions in unforeseen circumstances”.
There were 110 residents in the hospital on the inspection date.
Meanwhile, at the Carrigoran House nursing home in Newmarket-on-Fergus, Co Clare – a voluntary facility run by the Sisters of Charity of the Incarnate Word – inspectors were concerned that there were insufficient staff on duty in three of the four units at the centre to meet the needs of residents, particularly at night and in the mornings. “One nurse on night duty was responsible for 64 residents in two units,” says Hiqa’s inspection report, published yesterday.
“There were also some significant concerns identified in the areas of assessment, the care planning process and medication management. In some instances these concerns could be linked to insufficient staffing levels.”
There were 106 residents in the centre on the date of inspection.
The inspection report says some residents felt there were plenty of staff on duty, but others were not satisfied with staffing levels. One resident said that “sometimes you could ring the bell and the staff don’t come, and this could cause continence problems”.
At St Louis nursing home in Monaghan town, a voluntary centre caring for 17 religious sisters, inspectors found there were not enough temporary staff available to provide cover for periods of sickness and other absences, not all staff had received Garda clearance, and “inspectors observed residents being put to bed in the afternoon/early evening to accommodate staff numbers”.
The report also says “there is inadequate means of escape for residents in the event of a fire” and, given the dependency of residents and the number of staff on duty, inspectors concluded that “residents’ safety was not adequately protected”.
The HSE, in its response to Hiqa on staffing at St Patrick’s Community Hospital, said meetings had taken place to discuss and propose contingency arrangements to address the issues raised.
Carrigoran House nursing home told Hiqa it was reviewing proposals to reorganise the morning work of nursing staff. The skill mix on duty at night had been changed from three nurses and five care assistants to four nurses and four care assistants.
“This change has significantly increased the direct registered nurse-led care to our residents,” it said.
St Louis nursing home said its building was a protected structure, and all changes inside and outside were subject to planning permission. Furthermore, it said staffing levels have been reviewed and two sisters who work on a voluntary basis in the home were not shown on the roster.
While Hiqa also had positive comments to make about care provided in all the homes, it raised concerns about the structure of St Patrick’s hospital. In some instances there were up to eight residents in wards, with limited space between beds.
The home said a submission was “made to national HSE for a new designated purpose-built centre for Carrick-on-Shannon . . . However, to date approval has not been granted as it is not deemed a high enough priority”.