Lack of privacy for gravely ill residents found at Limerick nursing home

Residents at a nursing home in Co Limerick were unable to spend time alone with family and friends when they were seriously ill and approaching end of life, the State's health watchdog has found.

Inspectors from the Health Information and Quality Authority (Hiqa) said some residents at St Ita’s Community Hospital in Newcastlewest lived out their final days “being cared for in a five-bed room, with the curtains closed around the bed” and limited space for relatives.

The unannounced inspection, which took place last July, focused particularly on the quality of life of people with dementia. Of the 45 inspection reports published by Hiqa on Thursday on public and private residential centres for older people, evidence of good practice and compliance with regulations and standards were found in 32 centres.

The design and layout of St Ita’s, which accommodates 73 residents over three units, “significantly impacted” on the provision of care for residents who were seriously ill and approaching end of life, Hiqa found.

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“Due to the number of residents accommodated in many of the bedrooms, it was not possible for staff to provide adequate privacy to the resident as they approached end of life. This also had an impact on the privacy of other residents in the room,” it said.

“Residents were unable to spend time alone with their family member or friend when they were seriously ill and approaching end of life.”

Inspectors said the social care needs of residents were not adequately addressed and a large number spent long periods of time “in their bedrooms, either in bed or in a chair at their bedside”.

“Residents in sitting rooms were provided with little stimulation, other than the television, in which they had little interest.

“The activities co-ordinator was on annual leave on the days of the inspection and was not replaced. As a result, many of the activities listed on the programme of activities did not take place.”

Inspectors said there is a variation in the quality of accommodation in each of the centre’s three units. In two of the units, “not all opportunities to engage with residents were availed of and on occasion, staff were seen to come and go from the sitting room without interacting with residents”, it said.

There was a greater level of interaction with residents in the other unit.

The centre was generally “not clean” with evidence of dust in high areas and delays in cleaning stains.

The centre was also in a poor state of repair with damaged and chipped paintwork and evidence of stains on walls caused by dampness from long-term leaks.

Roscommon

Drumderrig House in Boyle, Co Roscommon was found to be non-compliant across a number of regulations including staffing, governance and management, documentation and risk management. The unannounced Hiqa inspection last August was triggered by “unsolicited information” supplied to the office of the chief inspector.

“This information conveyed that there were regular staff shortages, poor cleaning standards and that recruitment procedures did not reflect good practice standards for staff working with vulnerable people,” Hiqa said. “The concerns raised were substantiated by the findings on the day.”

Staff resources available were inadequate to ensure care was delivered in a safe, consistent manner, inspectors found.

There had been a reduction in the number of staff nurses and carers available due to resignations and illness absence in recent months.

Inspectors noted that several areas of the centre did not have a staff presence for extended periods after 8pm. In addition, upon reviewing the accident and incident record, inspectors discovered many falls were unwitnessed and measures to prevent further falls were unclear.