HIQA threatened to cancel Clare hospital’s registration

A NATIONAL health watchdog issued a notice to cancel the registration of an Ennis community hospital due to a history of non-compliances with regulations, writes Dan Danaher.
The Health Information and Quality Authority (HIQA) has confirmed its chief inspector issued a notice of proposal to cancel the registration of Cahercalla Community Hospital and Hospice earlier this year after an inspection in January and February found action had not been taken to address non compliances.

HIQA has confirmed the notice of proposed decision to cancel the registration of Cahercalla Community Hospital and Hospice remains in effect and has not been withdrawn.

This notice was addressed by Cahercalla, which outlined a revised organisational structure, after enlisting the services of Mowlam Healthcare to manage the centre.
HIQA stated Cahercalla had a “poor history of compliance with regulations, with repeated non-compliance in areas such as governance and management, individual assessment and care planning, health care and staffing”.
An inspection report completed after an unannounced visit on March 16 stated there were breaches of regulations concerning staffing, training and staff development and individual assessment and care plan.
The hospital was compliant in relation to regulations governing persons in charge, visits and health care and was substantially compliant concerning records, governance and management, complaints’ procedure, infection control and residents’ rights.
Inspectors spoke with a number of residents on the day on the inspection. Residents said that they felt safe and well looked after in the centre. They said that the staff
were kind to them and treated them with respect.
Residents told the inspectors that the national restrictions in place due to Covid-19 had been difficult but that they were very happy to have been vaccinated and felt
that things were changing for the better.
Inspectors observed improvements in the opportunities available to residents in relation to social engagement. A new activity schedule included group and individual activities
including, exercises to music, baking, bingo, arts and crafts, and pampering and relaxations sessions.
A residents’ forum had also been established and patients were updated on the new visiting guidelines.
Residents told inspectors that they enjoyed the food in particular the brown bread and cakes made on site by kitchen staff.
The report noted the new management team had reconfigured the accommodation in the centre reducing the units from five to four. This allowed for the reallocation of staff throughout the
centre.
Responding to issues, management has set up a comprehensive review of rosters to ensure that staffing levels and skill mix are always sufficient to meet residents’ assessed care needs. The person in charge will monitor the rosters closely to ensure that planned rosters are implemented in practice.
A member of the management team will always be rostered at weekends to ensure the consistent delivery of person-centred care, including the provision of a variety of interesting and meaningful activities, based on the expressed preferences of residents.
There are now three clinical nurse managers in post, including two recently appointed CNMs. One of the new CNMs is an experienced nurse who has been working as a staff nurse in the hospital until her promotion and the other is new to the hospital. Both newly appointed CNMs have completed an induction programme, supported by management.
Recruitment is ongoing to fill the remaining CNM positions and the assistant director of nursing is supporting the supervision of staff and care delivery.
The person in charge is supporting the induction and performance of the management team with support from the Healthcare Manager (HCM).
There is a weekly management meeting to assess progress and identify development needs and service priorities.
A new electronic resident record system has been introduced, resident data has been entered and a significant amount of time has been spent in ensuring that staff have been
trained how to use the system for recording assessment, care plans and all resident information.
There is a monthly management team meeting in the home. which reviews all operational aspects of the home, including key performance indicators, risk management, audits and progress on identified actions and updates on quality improvement initiatives.
The management team will promote a culture of openness and transparency, including encouraging feedback from residents and relatives, whether positive or
negative.
New measures and checks have been implemented to improve infection control, while there is no a weekly audit of of clinical documentation to ensure that each resident’s required care needs are addressed.