A Dublin nursing home administered drugs to a number of patients without prescriptions or authorisation from a doctor, a court heard yesterday.
Rostrevor Nursing Home, Orwell Road, Rathgar, is accused by the Health Service Executive (South Western Area) of 23 breaches of regulations relating mostly to the care and welfare of nursing home residents.
The alleged breaches relate to improper administration of drugs, lack of properly trained staff and inadequate standards of nursing care between April 2003 and May 2004.
On one occasion, bedsores on an elderly, incontinent patient were found to have been contaminated by faecal matter. The allegations are being contested by the nursing home owner Therese Lipsett.
At Dublin District Court yesterday, Marie Faughy, the director of public health nursing for the health authority, said there was no commencement date for administration of a number of controlled drugs, such as hydro-morphine and morphine sulfate.
Some of these drugs were stored for patients who were not resident in the nursing home, Ms Faughy said.
During a later inspection in May 2004, Ms Faughy noted that Valium was being administered despite being discontinued three months earlier. Cross-examined by Ms Lipsett's counsel Breffni Gordon, Ms Faughy accepted she did not examine the unlocked trolley to see if it contained drugs.
In relation to Ms Faughy's claim that controlled drugs were stored for two patients who were no longer resident in the home, she accepted that she did not know when these residents left.
Mr Gordon suggested the residents in question could have left the nursing home 24 hours previously, illustrating the "frailty of the evidence".
Ms Faughy said she found a gauze dressing on a patient not secured by tape which did not cover the area of the pressure sore. The patient was incontinent and faeces also covered the surface of the dressing and the area of the wound which was exposed.
"I asked that the dressing be removed and saw the wound was very large, the edges of which were very raw and very ragged," Ms Faughy said. "This would indicate that the type of dressing was inadequate for the extent of the wound."
The wound dressing for another elderly patient's bedsores were improperly attached, while another sore on the same patient's foot was left exposed.
Ms Faughy said the need to properly develop and implement a policy on treating wounds and pressure sores was one of nine conditions under which the nursing home had its registration renewed in 2003.
These conditions had also specially directed that the practice of leaving wounds exposed should cease. On three occasions Ms Faughy also noted the drugs trolley was unlocked and some drugs were on "open display".
