Report criticises standard of care at Spiddal nursing home

A nursing home in Connemara has been ordered to instigate a series of changes after inspectors identified several shortcomings, including some relating to inadequate staffing levels and health care risks.

Inspectors from Health Information and Quality Authority (HIQA), following an inspection of Áras Chois Fharraige, at Páirc, An Spidéal, were “very concerned that the provider was not ensuring that an adequate standard of evidence based care was provided to residents”.

They were also, “concerned that the provider had not completed actions required following most recent inspections within the agreed timeframes and previously agreed improvements which had been commenced had not been sustained.”

In its 38-page report, compiled following an unannounced inspection of the facility that took place over two days in September, HIQA issued an “immediate action plan” that listed six actions that had to be complied with immediately.

This latest inspection follows on an inspection in June, which was also critical of the nursing home.

“The inspectors reviewed the processes in place for the management of elder abuse and found that improvement was required in relation to the abuse policy, knowledge and understanding of elder abuse and management of behaviours that are challenging,” the inspectors’ latest report said.

It added: “The provider and person in charge had failed to manage a number of serious risks and the provider was requested to take immediate action to address these. The provider had put measures in place to protect the safety of residents, staff and visitors to the centre. However, there was insufficient hazard identification and controls put in place in relation to manual handling practices, smoking, access to dangerous substances and absconsions.

“The provider and person in charge had not taken measures to ensure that residents were protected by safe medication management policies and practices. Medication was not managed and administered safely. The inspectors identified some medication administration practices which were unsafe.”

The report found that medication errors “were not being suitably recorded and reviewed for learning and improvement of service”.

“The person in charge said that there had never been a medication error, although an inspector identified several medication errors in the course of the inspection,” it noted.

“The inspectors were not satisfied that each resident’s wellbeing and welfare was maintained by a high standard of nursing care and found that there were significant concerns in the management of nutrition, wounds, falls and epilepsy . . . Staff were not knowledgeable on the management of epileptic seizures. Staff had received no training in this area of care and there was no policy on care of residents with epilepsy.”

The inspectors report added: “The management of environmental risk, fire safety awareness and medication management were also identified as risks that required immediate action.

“The inspectors found that staffing levels and skill mix and staff supervision were not adequate and this impacted on the delivery of appropriate and safe care to residents.

“Issues relating to laundry services, privacy in shared bedrooms, provision of suitable recreational opportunities for all residents, staff recruitment, infection control and policies and procedures were also identified as non-compliant during this inspection.”