Nursing home residents were being wakened by 6am - Hiqa

Vulnerable elderly residents of a Waterford nursing home were being got out of bed, washed and dressed by 6am, the Health Information and Quality Authority (Hiqa) has found.

Some of them had been given sedatives and psychotropic medication the night before and one was observed asleep in a chair in the day room “throughout the morning”.

An unannounced inspection of Waterford Nursing Home, Dunmore Road, Waterford, operated privately by Mowlam Healthcare, was conducted on November 17th last year.

The authority had received two separate reports raising concerns about the home, hosting more than 50 residents.

Hiqa found “shortcomings in clinical leadership”, and four instances of “major” non-compliance with national standards and two of “moderate” non-compliance.

“After inspectors arrived at the centre, by 06.05 there were two residents awake and dressed and sitting in the day room, one resident upstairs and the second resident downstairs,” the report said.

“By 06.30 two further residents were dressed and sitting in the day room, while a fifth resident was being washed and dressed at that time.”

Night staff said they had been asked to have residents up and dressed to help the day staff, who started at 8 am.

Sedatives given

Four of the residents who had been woken before 6.30am had been give sedatives the night before. “One resident had received two different types of psychotropic medication the previous night,” Hiqa said.

This resident was up, washed, dressed and in the day room by 6.10am. Psychotropic medication is used to treat anxiety, depression and insomnia, and can be mind-altering.

Loud machines were being used to polish ground-floor floors soon after 6am, creating noise through the ground-floor area.

Reports that residents’ call-bells had been removed or unplugged at night had been made. The issue had been reported also to management and an investigation conducted. Inspectors found a new call-bell system in place.

However “the issue of staff unplugging call bells in an unauthorised manner had not been adequately investigated”.

A review of prescription and medication administration records found one resident was given a dose 50 per cent higher than prescribed.

An alleged incident of “suspected or confirmed” abuse of a resident had occurred on August 26th, 2015. It had been verbally reported by staff to the management the following morning, and in writing soon after.

However, Hiqa was not notified until October 30th.

According to Hiqa standards, incidents in nursing homes may be required to be notified to the authority.

Wound care

An allegation of poor wound care amounting to neglect of a resident was made. Management was aware of the complaint. Inspectors spoke to staff and reviewed care plans, but were “not satisfied” wound care management was in accordance with best practice.

Mowlam Healthcare, responding to the report, told Hiqa the residents who were up and dressed early had chosen to get up at that time.

The start time for cleaning staff had been changed to 8am.

All staff were to undergo medication competency assessments. Education on adult protection and on wound management would also be provided to staff.