A Hiqa report has found residents in one nursing home had no access to water and there were no meaningful activities organised for them, writes
JAMIE SMYTH
A NURSING HOME in Dublin has been ordered to improve the standard of care it provides to patients following an inspection, which found that a number of elderly residents had "dry mouths and cracked tongues" due to a failure to provide access to fluids.
A report by the Health Information and Quality Authority (Hiqa) also found that staff at St Pappin's Nursing Home in Ballymun were not engaging in a meaningful way with residents. They were also not managing properly those elderly residents demonstrating challenging behaviour, said the inspectors.
"The inspection found that the overall care delivered was not of a high standard. Lack of robust governance procedures in relation to risk management, clinical supervision, absence management and recruitment practices contribute significantly to the issues identified in the report," said the report.
Hiqa, which has the power to close down nursing homes which pose an urgent risk to residents, highlighted that access to water and choice of fluids was not available to residents at the home.
"Residents were not offered drinks on a regular basis. Residents told inspectors that they were thirsty and their mouths were dry. Inspectors saw residents with dry mouths and cracked tongues. On one occasion a highly dependant lady waited 10 minutes before being provided with a drink of water," said the Hiqa report.
In its response to the inspection report Silver Stream Healthcare, the company that runs the home, said it had conducted an inspection of all residents' mouth care and found three of them had dry lips and cracked tongues. It said it believed the condition was "attributed to prescribed medications" rather than a lack of fluids provided by the nursing staff.
Since the inspection, the nursing home has changed its procedures to provide a jug of water every morning to residents and to install water dispensers on both floors. It now provides each resident with an average of 1.2-1.8 litres of fluids on drink rounds every day.
St Pappin's Nursing Home provides accommodation for up to 59 elderly residents, some of which suffer from dementia, intellectual and physical disabilities. There were 36 residents present on the day of the inspection, which was conducted following safety concerns raised by a former resident.
Hiqa inspectors criticised the way staff managed residents with challenging behaviour, noting that some elderly residents who were shouting for attention were ignored. There was also a lack of meaningful activities laid on for residents, one of whom told the inspectors he was "bored stiff".
"The amount and quality of communication between residents and staff requires significant improvement, particularly for residents with dementia. Throughout the day, inspectors found staff were not engaging with residents in a meaningful way," they said.
The report provided an action plan to enable the nursing home to comply with the Health Act 2007. This would address inadequate clinical supervision and communication processes, recruitment and vetting procedures, lack of meaningful activities and aemergency plan.
However, the inspectors said they were satisfied that a recent change in key personnel was having a positive impact. They noted recent changes in practices at the home throughout the inspection process, which management considered would lead to improvements in the care delivered.
In its response to the report, the care provider acknowledged there were areas for improvement and said it was totally committed to developing its service. However, it also said it was disappointed not to find any recognition of the positive feedback received from families of residents at the home through a recent questionnaire.
This latest Hiqa report on the standard of care provided at St Pappin's Nursing Home follows on from several other critical reports issued in the past month. This month, the HSE was forced to take over the running of Glenbervie Nursing Home in Bray, Co Wicklow, following Hiqa's decision to get an interim court order to deregister the home on safety grounds.