Nursing home pledges upgrade following HIQA report

An ENNIS Nursing Home has pledged to carry out an upgrading of its premises and equipment following concerns expressed by inspectors during a recent visit conducted by an independent health watchdog.

Mowlam Healthcare Services has told the Health Information and Quality Authority (HIQA) a planned programme of refurbishment that was put on hold due to Covid-19 will be recommenced at Ennis Nursing Home, Showgrounds Road, Drumbiggle.

This will include painting, floor repair, upgrade to Bain Marie storage area in both dining rooms and repair to skirting and door frames.

The person in charge will ensure that the facilities team undertake a review of lighting, particularly near lift exit and corridors upstairs.

The PIC has completed a comprehensive review of all resident equipment. Any resident equipment deemed not suitable has been discarded and replaced; for equipment that required cleaning, a new tagging system has been introduced whereby cleaned items can be tagged after cleaning with a date stamp.

The management team will monitor compliance with the new procedure, which is currently working well. A review of the system will take place to ensure all residents have equal access to call bells.

Ennis nursing home is a purpose built, two storey in design and provides 24 hour nursing care. It can accommodate up to 60 residents over the age of 18 years. It provides long-term
residential, convalescence, respite, dementia and palliative care.

There were 58 residents in the facility during the unannounced HIQA inspection on June 15 last.

The nursing home was found to be compliant with national standards covering staff, governance and management, notification of incidents, complaints’ procedure, visits, health care and residents’ right.

It was substantially compliant with standards on training and staff development, records, infection control and premises, and was not compliant with the regulation on individual assessment and care plan.

There was evidence that residents were supported to enjoy a good quality of life by staff who knew them well. Feedback from residents was that they enjoyed a good quality of life, and were provided with the help and support they needed.

Resident informed the inspector that the ”food is first class”, ”there is no place on earth like it” that they were ”as snug as a bug in a rug” in their room and that they ”had good friends here”.

The inspector observed verbal and non-verbal communication, between staff and residents which was caring and patient. The inspector saw the lunch time dining experience promoted the respect of residents. The meals served were well presented, and there was a choice of food available.

Residents who required help were provided with assistance in a dignified manner. The inspector attended the morning staff handover which was informative and person-centred.

The inspector observed that parts of the premises were in a poor state of repair. Internally, parts of the premises were poorly lit, paint on walls, doors, and skirting
was marked and chipped. The inspector also observed that areas of the premises that was not visibly clean.

The inspector found that, overall, this centre was well resourced, with adequate staffing to support the residents to have a good quality of life. However, individual assessment and care planning, premises, infection prevention and control, training and staff development, and records did not meet the requirements of the regulations.

A review of the staff training records found that not all staff had completed up-to-date mandatory training.

The inspector found that residents received an appropriate quality of care from staff who knew the residents well. However, action was required to ensure that individual
assessment and care plans, infection prevention and control, and the premises were compliant with regulation.

Inspectors reviewed a sample of resident records, and found that care plans did not always contain the information required to guide the care, and did not always reflect the care needs of
the residents.

The inspector was informed that cleaning hours within the centre had been increased by four hours per day, however, this had not been implemented at the time of inspection. The inspector
observed many areas of the premises that were not cleaned to an acceptable standard.

The inspector found both dining rooms were in a poor state of repair. The area where a Bain Marie was stored had damaged flooring. The laminate was lifting off the wooden surround, and the paint was cracked and peeling.

Lighting was not consistent though out the centre. It was dim at the lift exit and outside two resident bedrooms, increasing the risk of slips, trips and falls.

Paint work was generally in a poor state, with walls marked, paint lifting on the fire place in the visitors rooms, paint scuffed on skirting, doors surrounds and resident bedroom doors leaving exposed wood.

There were holes in the floor on the first floor, impacting on the cleaning of the centre. Chair coverings were worn, bed tables with laminate covering lifted, and one resident commode was visibly rusted.

In its response, the centre pledged it would ensure that all staff have received up to date mandatory training and education in line with legislative and regulatory requirements.

The induction programme for nursing and care staff includes a competency assessment of fundamental care skills, including maintaining skin integrity, management of responsive behaviours and assisting a resident at mealtimes/monitoring nutritional intake.

The centre has reviewed storage of resident records and there is now a system in place that ensures all resident records are stored securely in a locked cabinet.

The person in charge will conduct a daily walk around of the building with the ADON to monitor standards of cleaning and identify any deficits to the housekeeping supervisor.

This person will facilitate safe cleaning practices and procedures for housekeeping staff, ensuring that they refer to the housekeeping manual for guidance regarding best practice if required.

A care plan will be prepared within 48 hours of each resident’s admission which will reflect the individual resident’s assessed care needs and preferences.