Cork care home called to ‘cautionary meeting’ with Hiqa

Management at a Cork nursing home were summoned to a "cautionary meeting" with the head of the Health Information and Quality Authority (Hiqa) inspection team following concerns detected at the facility in August.

The Glendonagh Residential Home near the village of Dungourney in east Cork, was found to be operating outside of its conditions of registration and was asked to attend the office of the chief inspector to discuss its findings, a relatively unusual move in the oversight system.

The home caters for 43 residents and was judged to be non-compliant in six areas of inspection.

It was just one of 49 care facilities for which recent inspection reports produced by Hiqa were published on Monday. Of those, good practice and broad regulatory compliance were found in 17 inspections while 32, or two thirds of the homes, were found non-compliant to varying degrees.

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Non-compliance issues were in the areas of governance and management, infection control, fire precautions, residents’ rights, notification of incidents, care plans and risk management.

Glendonagh had a lack of both senior nursing staff and personnel giving activity provision for residents. There was also evidence of a lack of effective systems in place to monitor infection control procedures including cleaning.

Inspectors noted high levels of non-compliance in relation to fire safety while the residents’ personal files were inappropriately stored and unsecure, including in the hair salon during renovations.

The report recorded a “warm and welcoming atmosphere” and residents told inspectors it was a nice place to live. The centre continued to remain free from Covid-19 infection.

However, there were a number of ongoing issues and the Hiqa inspection team felt night nursing staff levels were inappropriate to meet the needs of the 43 residents.

Staff members were found not to be up to date on various training including fire safety, managing responsive behaviour, and the detection, prevention and response to abuse.

CCTV use

At the Teach Altra facility in Newmarket, Co Cork, the visit found concerns around CCTV use. A display panel on the corridor beside a bedroom had four observation panels displaying pictures of residents in the day room and dining room.

“Residents would have the expectation of privacy and respect; having their movements viewed by passers-by would not be in keeping with a rights-based approach to care,” the inspector found.

Teach Altra, which was catering for 28 people on the day of the inspection last June, was deemed non-compliant in nine areas.

While its residents gave positive feedback about staff, inspectors raised various concerns including inadequate oversight of fire safety management; a lack of appropriate staff supervision; poor oversight and management regarding the use of restraint; and an ineffective complaints procedure.

The physical environment in the centre had not been managed and maintained to effectively reduce the risk of infection, the report noted.

Willow Brooke Care Centre in Castleisland, Co Kerry, was considered non-compliant in eight areas of inspection, although, again, residents "spoke very positively" about it and said they were happy living there.

While they complimented the quality of their surroundings, Hiqa felt the number and skill mix of staff was insufficient and noted there was just one activities co-ordinator in the centre – residents living upstairs did not have full access to activities.

A number of staff had begun working in the centre without training in infection control (44 per cent of staff) and hand hygiene (59 per cent), a deficiency found to pose an increased risk due to the Covid-19 pandemic.

Medication errors within the centre were not found to be not appropriately investigated, the inspectors found. Also, notifications had not been sent for a number of incidents including two in which residents were transferred to hospital, and one of professional staff misconduct.