Inspectors voice serious concern over care home

Standards at a Dublin nursing home have been severely criticised by inspectors from the Health Information and Quality Authority.

An unannounced inspection of the Shrewsbury House nursing home in Drumcondra last August found “significant failings” in compliance, according to a report by the authority.

These included a failure to ensure the person in charge was working full-time, inadequate procedures to guide staff, a failure to ensure robust risk management and a lack of supervision of staff. The home was also faulted for a failure to protect the safety and welfare of residents, poor hygiene and infection control.

“The lack of ongoing regulatory compliance, standards of complaints management, poor documentation, and failure in regulatory requirements to notify of allegation of abuse and a serious incident resulting in fracture indicate a less than robust standard of management and governance of this centre,” the report says.

It relates a number of concerns raised by relatives, in particular about one resident who sustained a fracture after a fall. The authority says it received no notification of an earlier fall, which had resulted in the person’s admission to hospital.

Hygiene

The home, a family-run operation on Clonliffe Road, said it had faxed details of the fall to the agency but was unable to provide a fax receipt by way of confirmation.

The standard of upkeep and hygiene at the centre was found to be inadequate. Many areas had visible dirt and cobwebs, and bathroom tiles were dirty. The inspector was not satisfied with the cleanliness of several areas, but was told they were due to have a “deep clean”. The internal courtyard paving was overgrown with weeds and contained broken furniture.

The authority says an inability to manage and document complaints has been a recurrent issue in its inspections. In this case, inspectors found complaints were not responded to appropriately. The recording of the results of investigations into complaints was not properly maintained. Insufficient evidence was recorded of actions taken on foot of a complaint.

Privacy

Adequate arrangements were not in place to ensure the centre operated with due regard for residents’ privacy and dignity, the report says. Staff notices on the use of continence products and “the classification of bowel movements” hung in bathrooms, and shared rooms had inadequate screening.

The home responded by saying the person in charge was now working there full-time and renovations were planned. It said bed linen was changed regularly and new checks had been introduced for residents who made their own beds.

It said an allegation of “rough handling” by a resident was not an official complaint but was said in passing. Two staff nurses had been given written warnings over medication errors and had attended a refresher course in medication management for older people.