HSE takes over at nursing home after inspection

THE OWNERS of a nursing home in Co Galway were ordered to cease operating last month after nursing home inspectors expressed “grave concern” for the safety and welfare of up to 22 residents.

Inspectors from the Health Information and Quality Authority (Hiqa) found evidence of poor management of medication and inadequate staffing levels at the Owen Riff Nursing Home – a family-run facility in Oughterard.

They also found some residents were “unkempt and unshaven”, and many had not had a bath or shower during the previous month. Instead, the use of a sponge was recorded.

In addition, there were concerns over meals being served late. In one instance, some residents were observed receiving their breakfast when it was almost dinner time.

The registered owner – Riverside Nursing Home Ltd – was ordered to cease operating the facility last month, and later withdrew an appeal against a closure order. The Health Service Executive (HSE) has since taken over the running of the facility.

In reports published yesterday afternoon by Hiqa, inspectors reported that dozens of key concerns highlighted in previous reports relating to the management of medicine, care planning and risk management had not been acted on.

Among their findings were grave concerns over low staffing levels and an inadequate skill mix to meet the needs of the residents and ensure their safety.

Inspectors were seriously concerned that residents at risk of malnutrition were not managed appropriately, and found that main meals were being served on side-plates.

Some of the most serious findings related to the condition of residents.

In an announced inspection between April 20th and 21st of this year, inspectors noted that “throughout the inspection residents were noted to be unkempt and their hair not brushed or combed. Some residents’ clothes were not ironed while many residents’ clothes were dirty.”

In addition, “residents’ fingernails were not cared for and required cleaning and trimming. Male residents were unshaved. There was a ‘bowel/shower’ book in use, this indicated that the majority of residents did not have a bath or shower in the previous month; instead ‘sponge’ was recorded.”

The report noted that some staff were out on long-term sick leave and one nurse had left the service since the previous inspection.

There were two care assistants on duty and one agency nurse on the day of inspection. Inspectors said staff were hurried and had no time to communicate with each other or with residents.

“Some residents were receiving their breakfast when it was almost dinner time.

“One resident was noted sitting in the dining room calling for assistance, there was no staff member to respond. This resident was unkempt, unshaven and his eyes were crusted and sore,” the inspection report states.

Residents who had falls were not routinely referred to the GP for check-ups. One resident sustained four falls, two resulting in head injuries.

Inspectors said previous action plans drawn up by the nursing home provider were inadequate because they did not outline what actions the provider had taken or intended to take to address requirements to ensure residents were safe.

On foot of the Hiqa reports and legal proceeding which began in late April, Galway District Court issued a closure order on July 4th. The owners later withdrew an appeal to the Circuit Court and the order was confirmed on July 31st last.

The HSE took over management of the facility. In a statement yesterday, it said another private provider was currently working to secure registration. In the meantime, the HSE remains as registered provider.

Owen Riff Nursing Home was described as a family-run nursing home in Oughterard which opened in 2003. It had places for 40 residents, though there were 22 receiving long-term care at the time of the inspection.

Some of these residents were described as having cognitive impairments and dementia-related conditions.

OWEN RIFF NURSING HOME KEY INSPECTORS' FINDINGS

Among the findings of inspectors were:

Grave concerns over low staffing levels and an inadequate skill-mix to meet the needs of the residents and ensure their safety.

Inspectors found some residents were "unkempt and unshaven", and many had not had a bath or shower during the previous month.

In one instance, some residents were observed receiving their breakfast when it was almost dinner time.

No evidence that residents had a medical review carried out or their medications comprehensively reviewed since the previous inspection, or that such actions were planned.

Inspectors were seriously concerned that residents at risk of malnutrition were not managed appropriately, and found main meals were being served on side-plates.

The number of medication errors and poor overall medication management posed a risk to the safety of residents.

There was limited access to allied health professionals and no residents had been referred to physiotherapy, dietetic or speech and language services.

Significant concerns in relation to the fitness of the person in charge of the nursing home, who was "disorganised" and did not demonstrate strong leadership skills.