Health Service Executive (HSE) inspectors who visited a nursing home in Enniscrone, Co Sligo, last October found four patients physically restrained in their chairs and many patients still dressed in their night attire at 11.30am. John Downesreports.
In a separate report placed on the HSE website yesterday evening, inspectors also expressed concerns about the adequacy of an alarm system at Blair's Hill nursing home in Sunday's Well, Cork, after accident records showed that in September 2006, a "mobile patient suffering from dementia managed to leave the home and was found in the car park".
Another resident also absconded from the home in January 2006, prompting management to install alarms on all exits.
"You are advised to put in effective controls to stop residents wandering from the home immediately . . . (or) current residents who are at risk of wandering must be found an alternative placement and you must not accept such persons as residents," the report states.
During the same unannounced inspection last December, the home was advised that it did not have the facilities to care for a resident who was at high risk of self-harm and who had succeeded in harming herself on two occasions. It was instead advised to seek "appropriate care and placement of this patient".
Inspectors who visited the Sancta Maria nursing home requested that significant improvements be undertaken to bring the building up to standard.
"A cloth restraint was placed around the patient's abdomen and chest and tied behind the chair," the report states. "One patient's movements were severely restricted. A patient in the upstairs area was restrained in her chair in her bedroom and did not have a call bell accessible to her."
When this was queried with the nurse in charge, she said carers checked on the patient regularly and that she would be in danger of falling if not restrained. But when the restraint consent for each of the four patients was checked, the report states that while it was signed by a nurse or relative, there was no restraint protocol to refer to before signing. "It was not apparent if any assessment had been made about the need for restraint or if the GP or a psycho-geriatrician had been consulted before starting the restraint," it states. "Restraint should only be used as a last resort and following consultation with GP or psycho-geriatrician if relevant."
The report also requests that all patients who are not fully bed-bound be dressed and encouraged to sit out of bed. Among the other concerns highlighted in the report are cramped conditions; a lack of emergency call bells at each bed; and inadequate fire escape routes and procedures.
The owner of the Sancta Maria Nursing Home, Terry Cawley, yesterday claimed that he is facing the prospect of closure as a result of the inspection report.
Speaking on RTÉ radio, he said that since switching to a new restraint protocol requested by the inspector, one female resident had fallen down and fractured her hip. He said the home had been in business for 17 years, and been registered "without conditions" during that time.
Referring to the HSE's requirement that extensive work be carried out on the building, he said he had been given just three months to do so.
"Its a major job, I feel at this stage that I don't have any option but to close my doors."