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Nursing home building ‘a significant challenge’


PROBLEMS with the building and a number of unacceptable practices were found at a HSE facility in North Clare, it emerged this week. However, a report by the Health Information and Quality Authority (HIQA) on Ennistymon Community Nursing Unit found residents were “cared for in a safe environment and that their nursing and healthcare needs were being met”.
The HIQA report, based on an announced inspection on April 11 and 12, and released last week, showed unacceptable practices were found at the facility and that the building in which it is housed provides “a significant challenge to comply with regulations”.
According to the report, risk assessments were completed in 2009 but had not been updated or reviewed at the unit since. Inspectors noted that all risks had not been identified, including risk of needle-stick injuries and risks of moving and handling injuries and that significant improvements were required in this area and in ensuring that all staff received fire safety training.
Responding to the report, the HSE stated fire prevention training was provided since the visit and that risk of injuries pointed out in the report had now been entered into the risk register.
The report stated inspectors observed one instance of a resident’s dignity and privacy not being observed in the daycare centre dining room.
“The nurse was observed about to give an injection to a person while he was seated with others at the dining room table. When the inspector was seen entering the room, the nurse was told not to administer the injection by another nurse,” the report stated.
The provider pledged to have written guidelines on the specified areas of administration of injections introduced by June, adding that injections are now given in privacy.
Inspectors also found that a number of radiators in residents’ bedrooms and day rooms had “extremely hot surface temperatures” and “this posed a risk of burning to residents”. The HSE stated that it planned to have sourced valves with a lock-out facility to prevent radiators being turned up to unsafe temperatures by June this year.
The report also noted that limited communal, private and recreational space for residents and visitors resulted in “many residents having to remain in their bedrooms for most of the day”.
Inspectors also observed residents eating their meals at their bedside or in one of the small day rooms and stated, “this arrangement did not allow the dining experience to be an enjoyable, social and interactive occasion”.
Following the inspection, the provider stated an area has been identified for a dining room within the existing building and the design specification will be drafted and go to tender. The response also stated there is a room and a seated area available for communal, private and recreational space for residence and visitors but said they would “increase awareness of these private areas through the residents’ forum, relative forum and notices. The residents’ guide will be reviewed to encourage the use of these areas.”
Inspectors found there was no separate room for residents to meet visitors in private and there was no separate smoking room.
The response added, “The tobacco inspector has recommended the present smoking area” but that the development control plan will have a designated smoking room identified.
The Ennistymon Community Nursing Unit building was used as a hospital until 1976, when it became a residential centre for older people. The building itself is the old workhouse located just off the Lahinch Road and the unit, which has capacity for 28 residents, housed 22 on the days of the inspections. HIQA noted that 10 of the residents were maximum dependency.
The report also noted “evidence of good practice in all areas”.
Inspectors stated that while the building has limitations with regard to space, size and layout, management has strived to improve the décor of all communal areas and bedrooms.
Inspectors found, “The provider and person in charge provided strong leadership and delivered a good quality service to residents”. They also noted, “evidence of good practice in all areas”.
“The provider, person in charge and staff demonstrated a comprehensive knowledge of residents’ needs, their likes, dislikes and preferences. Staff and residents knew each other well, referring to each other by first names. Residents were observed to be relaxed and comfortable when conversing with staff,” the report said.
Overall, inspectors were satisfied the residents were “cared for in a safe environment and that their nursing and healthcare needs were being met”.
Inspectors observed an adequate ratio of staff to residents during the inspection and staff rotas confirmed these staffing levels to be the norm.

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