SERIOUS SHORTCOMINGS have been identified in the way in which allegations of elder abuse were dealt with at a nursing home run by the Health Service Executive in Trim, Co Meath.
A report of an independent inspection of St Joseph’s Community Nursing Unit by the Health Information and Quality Authority (Hiqa), which was published yesterday, states the person in charge of the facility failed to investigate the allegations in accordance with HSE policy.
“The investigation had not been initiated in a timely manner and there was a lack of robustness in the approach. Relatives had not been informed and the only persons interviewed were the person making the allegation and the staff member named. No immediate protection measures for residents had been introduced,” the report says.
The home was inspected by Hiqa in September – by which time three allegations of elder abuse had been made against a nurse in the facility – but the nurse was not placed on administrative leave until November “following two further incidents of alleged abuse”.
Hiqa said it was not informed of these further incidents, or the initial three allegations of elder abuse, within the timeframe required by current regulations.
Hiqa has now lodged a complaint with An Bord Altranais around the fitness to practise of the nurse concerned.
Inspectors who visited the nursing unit also found the management of complaints was unsatisfactory. They identified a number of complaints that had not been investigated and there was no documented evidence of any learning following the investigation of complaints.
In addition, they found staffing levels at night time were inadequate. The home is divided into five units and while there were two staff – one nurse and one attendant – on duty between 8pm and 8am in each unit, this was “insufficient to meet the needs of all 147 residents if there was a need to evacuate in the event of a fire”.
Furthermore, there was “no plan for the emergency evacuation of the centre” and the working patterns and rostering of staff did not always ensure continuity of care or maximise residents’ safety. There was also a lack of management supervision at night and an over-reliance on agency staff.
The report also says inspectors found “there was poor leadership and management in the centre which directly impacted on the care provided to the residents”.
There was also “evidence of institutionalised care practices”, with residents, for example, remaining in bed routinely, showers being based on routine rather than individual preferences and laxatives being routinely administered.
Insufficient numbers of toilets and bathrooms to meet the individual needs of residents, poor infection control and inadequately maintained floor coverings were among other findings by the inspectors. They also noted that residents’ medical care had not been routinely reviewed by GPs.
The HSE said management and staff were committed to addressing the matters outlined in the report. It said some issues had already been addressed and it had devised an action plan to address others. Elder abuse training is now provided for all staff.
It added that all allegations of abuse were considered to be a serious matter and any such allegations are managed under its Trust in Care and Elder Abuse policies.
“Currently, a staff member is on leave pending investigation. Management wishes to provide assurance that any allegations which may arise in the future will be managed in a thorough and robust manner and in accordance with HSE policies and legislative requirements,” it said.
It also said the infrastructure of the building, which partially dates from the 1840s, presents obvious challenges but the HSE has in place ongoing maintenance programmes which mitigate these deficits. A number of windows were found to be draughty during the inspection.
Age Action said the report was a cause for serious concern.