A DUBLIN CARE Home which was unable to facilitate daily showering for some residents who required assistance due to staffing difficulties was amongst those found to be largely non-compliant with health and safety regulations.
The Health and Safety Information and Quality Authority (HIQA) released 50 unannounced inspections reports for older person’s residential centres today.
Of the centres that were assessed, 15 were found to be compliant during special inspections into the use of restrictive practices (which means techniques used to manage challenging behaviour), and 16 were found to be fully or substantially compliant in general inspections.
The Tara Winthrop Private Clinic was amongst the 129 centres found to be non-compliant with standards in area such as infection control, layout of the premises, resident’s rights, and staffing levels.
While the inspection report on the Tara Winthrop clinic noted that residents said the staff were “lovely”, and the inspector who visited noted many “kind interactions” between staff and residents, and reported that loved ones of residents said staff often “go above and beyond” for them, it also found that residents believed that there were not enough staff members in place, or enough management support for staff nurses.
An inspector who visited the centre on 19 June this year reported that two residents who spoke with them said that at the clinic, they were unable to have showers on a daily basis, despite doing so prior to their admission.
The inspector spoke to staff, and they confirmed that bathing and showering was facilitated once or twice a week, rather than daily for these residents.
The centre provides care for 119 adults across 5 units, with the majority staying in single occupancy rooms, and 29 staying in twin rooms.
The inspector found that those in twin rooms did not have enough individual floor space, or storage space.
However, their report did note that the Tara Winthrop clinic is warm, and largely comfortable for residents, with well-mainted internal gardens they can access.
The inspector also uncovered safeguarding issues at the centre, as three incidents that were reported by staff were not escalated to the HIQA Chief Inspector by management.
Residents also told the inspector that the activities they were provided were not always suitable to their needs or capabilities, and that in general, there weren’t a lot of activities in the mornings.
For example, residents who had lost full functionality in their upper limbs were being provided with bingo as an activity, but they couldn’t actually play the game.
In one unit, it was found that there was a lack of activities planned throughout the day.
The inspector found residents sitting in front of a television which was switched off, with their seats arranged in rows so they were facing each other’s backs.
Some were asleep, while others remained silent.
When the inspector asked a staff member why the TV was switched off, it was turned on, and a cartoon programme was left on.
“This was not appropriate for residents,” the inspector noted.
The inspector also wrote that some care-practices which were “institutionalised” rather than person-centered, which included residents having allocated days for showering, being put to bed without being asked if they wanted to go or consented to it, and having bibs put on them during meals without consent.
Cleaning was also an issue in some cases, as the inspector observed unclean shower chairs and nebulisers, which introduced a possibility of cross-contamination.
The staffing issues in the centre, the inspector noted, meant that some residents reported waiting 30 minutes to get assistance to go to the toilet, and meant that Clinical Nursing Managers were sometimes having to do the jobs of staff nurses.
At times, there were only four nurses to cover the night shift at the five unit clinic, the inspector wrote.
HIQA put the Swords-based clinic on a compliance plan, and many of the issues that were flagged in the inspector’s report have been addressed, or are in the process of being addressed.
For example, two new activities coordinators are being recruited for, and more regularly scheduled meetings have been arranged for at management level to ensure that safeguarding concerns are addressed, and incidents are reported.
“Weekly meetings will be held by the Senior management team and group management team to improve oversight of any outstanding actions [related to the HIQA compliance plan],” the person in charge at the clinic wrote.
The clinic has also introduced more suitable tools for determining the level of dependency of a resident.
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