THE HEALTH Information and Quality Authority (Hiqa) has found a “high standard” of nursing and medical attention for residents at a private nursing home in Galway.
In its first published report since it took over the role of independent inspectorate of all public and private nursing homes in July, it is positive about the care at Pointe Boise in Upper Salthill but also expressed some concerns.
Previously, only private nursing homes were inspected and these inspections were carried out by the Health Service Executive (HSE).
The Hiqa inspection of the Salthill home, which the owners were notified of in advance, says inspectors were “satisfied that nursing, medical and other healthcare needs of the residents are met”.
The purpose-built home opened in 2002, and is registered to care for 29 residents. There were 26 residents in situ, and one resident in hospital at the time of the inspection.
Some six residents were interviewed, the report says, and other residents’ views were sought “randomly” throughout the day of the inspection.
With one exception, a high level of satisfaction was reported, with a choice of good food for residents highlighted.
Residents spoke of being made to feel welcome, and of having the freedom to go out and visit friends, play bridge and attend a nearby church.
The report records good communication between staff and residents, and notes that a residents’ forum is in place.
The providers take a “positive approach” to quality improvement, with weekly in-house team meetings, it says.
But the inspectors were “concerned” that managers and staff were “not adequately prepared” to respond to outbreak of a fire, and they also observed that best practice in infection control in a community setting was not met at all times.
The report notes that there were only three staff members on duty each night, and that the safety of residents on the upper floor was of “particular concern” in the event of a fire, as some used wheelchairs.
Staff were trained in fire outbreaks on induction, but there were “inadequate” arrangements for continuing training, the report says.
On infection control, it found no arrangements for disposal of clinical waste, unsuitable taps at the hygiene station, and failure by staff to remove gloves on occasions when leaving residents’ rooms.
Also, the medication policy reviewed by the inspectors was “not in line with legislative requirements”, with no traceability in safe disposal of drugs, other than controlled drugs, and no guidance for faxed prescriptions or transcribing of prescriptions by nurses.
The report includes an action plan drawn up to implement recommendations. It also published a response from the nursing home which received a draft of the report.
While the home welcomed the findings in relation to good practice, it said that the inspection took place over one day only which was “unfair on the inspection team as this was too short a time to gather evidence”.
It also said that it did not receive the Hiqa guide to registration and inspection until afterwards. The lack of advance knowledge about the inspection’s format had an “unhelpful effect” on its management teams, including “confidence, morale and esprit de corps”.
It was also “hard for our residents who felt all the questioning difficult, and later expressed a view that a three-person team in-house all day in their place was too much for them”, the home said.
“We were the first privately- owned and operated nursing home in Ireland to be inspected by Hiqa and also the first home to receive the draft report. Inevitably, publication of the first reports will receive an inordinate and disproportionate interest,” the home added.