An investigation into the treatment of patients at Killarney Community Hospital has been frustrated by a lack of records, the report of the inquiry says.
The investigation, which covered a 15-year period up to this year, found that patients sometimes had to go to the toilet in the hospital dayroom. It also found that official guidelines for the administration of drugs were breached at the hospital.
The complaints came from former patients or their representatives, employees and a former employee.
The Southern Health Board, which runs the hospital, yesterday issued a heavily-edited version of the report of the inquiry. The edited version gives less than a page of the findings of the investigator, Ms Noreen Spillane, a director of nursing with the Mid-Western Health Board.
Despite a widespread absence of records at the hospital, Ms Spillane's findings support many of the complaints received. Complaints were first brought to the Southern Health Board on behalf of local families by Kerry County councillor, Mr Brendan Cronin.
Employees and a former patient complained about inappropriate practices in relation to toileting, including a refusal to assist a patient when going to the toilet.
One woman complained her husband was administered a sleeping tablet against his will. Ms Spillane found the drug administration policy "does not meet the requirements of the guidelines set out by An Bord Altranais. More specifically, in the records made available to the inquiry, there is no documentation relating to the actual administration of medication to individual patients".
This woman also complained she was refused permission to stay overnight with her husband, who subsequently died in her absence. Employees also complained of "a lack of understanding for relatives' concerns". Ms Spillane noted there was inadequate nursing cover to meet the needs of patients over 24 hours.
One patient said he had to be washed and shaved by his wife. A representative of one patient said he was not washed during one stay in the hospital and developed pressure sores and was unkempt during another stay. A former employee made a similar complaint about a patient.
Ms Spillane noted a confusion about who should provide care such as shaving to patients. She criticised the way in which non-nursing staff responded to bleeps and also criticised the absence of guidelines "relating to any issue pertaining to the delivery of patient care".
The investigation, according to Ms Spillane, was hampered by an absence of documentation and records. This included:
Absence of nursing records detailing nursing decisions and implementation of patient care;
Absence "of any documentation by the medical officers in the medical records pertaining to the admission, treatment and discharge of patients". (Currently all records of this nature are held by the medical officers in their surgeries, she added);
A previous practice of keeping medical records for only five years prevented the investigation of three complaints;
Absence of records of medication given to individual patients breached Bord Altranais guidelines.