Cork nursing home failed to notify Hiqa of unexpected death

A Health Service Executive nursing home in Co Cork is the latest to face strong criticism for serious failings from the Health Information and Quality Authority.

While the authority said residents of the 26-bed St Joseph’s Community Hospital in Millstreet “received care to a good standard” it found the facility failed to notify the authority of the unexpected death of one patient, lacked adequate sanitary facilities and suffered from staff shortages.

The authority also said inspectors were not satisfied there was “a comprehensive system in place to review the quality and safety of care on an annual basis” or that there were adequate systems in place “to ensure the service was effectively monitored”.

It said consent for the use of restraint was not always obtained from the residents, where applicable. Risk assessments did not always identify the risk of injury associated with restraint, and records identifying alternatives to restraint were not always completed.

In relation to the premises the inspectors found a number of deficits including unsuitable bedroom accommodation, inadequate communal space including dining facilities, inadequate sanitary facilities, storage space for personal belongings and the premises was not found to be in a good state of repair.

The report said accommodation was in two eleven bedded rooms, two single bedrooms and one twin bedroom. The 11-bedded rooms did not afford residents adequate privacy or dignity, the report said.

The male day room in particular could only be accessed by going through the male dormitory, resulting in the dormitory being used as a thoroughfare by visitors and staff while some residents remained in their beds.

There was evidence of damage to walls due to dampness and tiles were damaged while cleaning materials were stored in a toilet. Toilet facilities were not suitably located to be easily accessible, the report found.

Improvements recommended by the report included staff training, emergency planning, staffing levels and medication management.

Hiqa has now given St Joseph’s a series of deadlines for upgrades to its service and to its buildings.

The authority said from the end of July individual care plans based on assessments of residents’ conditions should be prepared “no later than 48 hours” after admission.

A risk management policy is to be in place by September to outline the measures and actions in place to control potential abuse.

It said provision for an annual review of the quality and safety of care should be in place by November, as should an exploration of alternatives to the use of restraint.

A comprehensive review of the laundry process to determine why clothing was going missing is to be carried out by September and the authority also gave St Joseph’s until the end of July to provide quarterly reports to the authority’s chief inspector.

During the review of facilities at St Joseph’s the inspector met a number of residents, their relatives and members of staff. The report indicated that despite the issues identified, the inspector found the residents did receive “care to a good standard”.

The inspector also found the person in charge was knowledgeable of her obligations “and demonstrated a commitment to providing a high standard of care to residents”.

“Nursing and care staff were knowledgeable of residents’ needs and provided a high standard of care. There was also good access to GP services, including out-of-hours and residents were referred for review by allied health or specialist services when indicated.