Quarter of nursing homes inspected in breach of multiple regulations - watchdog

More than a quarter of nursing homes inspected in the latest round of regulatory checks by the State’s health service watchdog were found to be in breach of three or more healthcare regulations.

The Health Information and Quality Authority (Hiqa) found during inspections that 26 out of 38 nursing homes were not complying with at least one healthcare regulation. Eight residential care homes were found to be in breach of two regulations.

Oakwood Private Nursing Home, a 56-bed care facility in Roscommon, had one of the highest levels of non-compliance. It was found to be in breach of eight regulations including on staffing, governance and management and infection control.

The regulator found during an inspection in January, when the nursing home was experiencing a Covid-19 outbreak with three residents testing positive, that there was “staff crossover” between residents who had tested positive for the disease and others who had tested negative.

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‘Less than ideal’

“Although inspectors were informed that infection prevention and control measures were in place, this arrangement was less than ideal and did not ensure ongoing containment of infection,” the inspection report said.

Inspectors expressed concerns about the level of staffing saying that it was “difficult” to assess whether the levels were adequate to meet residents’ needs.

It found nursing levels remained low, especially during at night when only one nurse was on duty. These staffing levels did not allow the “cohorting” of Covid positive and “not detected” residents in line with the home’s contingency plan.

Ferbane Care Centre, a 65-bed nursing home in Co Offaly with 55 residents, was also found to be in breach of eight regulations with "repeated" non-compliance on rules on staffing, management and infection prevention.

“There was inadequate monitoring and oversight of resident care to ensure the safety and protection of residents at all times,” the regulator found during two inspections last December.

Hiqa found there were 12 staff vacancies including in nursing, healthcare assistant and activities roles and that activities for residents were “curtailed as a result of insufficient staffing”. Insufficient staffing was also identified on inspections in December 2018 and September 2020.

The watchdog raised concerns about the management of a risk register where 25 incidents recorded since September, including 13 falls by residents, had not been reviewed or had “corrective action” taken in response. There was no indication that lessons had been learned from these incidents as there was evidence of repeated falls involving the same residents, it said.

Hiwa also found that two staff members had started work at the nursing home without a valid Garda vetting disclosure being processed.

Staffing levels

Kilminchy Lodge Nursing Home in Portlaoise, run by private nursing home operator Brindley Healthcare, was found to be in breach of eight regulations, including in the areas of risk management and infection control, during an unannounced inspection in December.

The regulator raised concerns about staffing levels saying that inspectors were not fully assured that the number of staff was sufficient if the nursing home was operating at full capacity.

“It was observed that for some residents it was lunchtime before they received assistance with personal care and could leave their bedroom,” the inspection report says.

Hiqa said the infection prevention and control practices at the home, which experienced a severe Covid-19 outbreak in October 2020, were not consistent with national standards.