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25 care homes non-compliant with some regulations

Twenty-five residential centres for older people are not compliant with some regulations, according to the Health Information and Quality Authority.

Fifty inspection reports have been released by HIQA, carried out over an eight-month period between May and December 2023.

Some 21 centres were found to be non-compliant with three regulations or less and four centres were non-compliant regarding four or more regulations.

Non-compliance was identified in areas including governance and management, training and staff development, notification of incidents, healthcare, fire precautions, staffing, personal possessions, and residents’ rights.

However, overall HIQA inspectors reported evidence of good practice and compliance with the regulations and standards.

Nine inspection reports focusing on the use of restrictive practices were found to be compliant or substantially compliant with national standards for Older People in Ireland.

A further 16 centres were either fully compliant or substantially compliant with the regulations.

In general, these centres were found to be meeting residents’ needs and delivering care in line with the national standards and regulations.

HIQA said in centres where non-compliance was identified, the providers were required to submit compliance plans to demonstrate how they will make improvements and come into compliance with the regulations.

Nursing home in Dublin among several flagged as non-compliant

Lucan Lodge Nursing Home in Dublin was among a number of providers listed by HIQA as being non-compliant.

This is regarding regulations under the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013, Health Act 2007 (Registration of Designated Centres for Older People) Regulations 2015 and the National Standards for Residential Care Settings for Older People in Ireland.

The facility at Lucan Lodge is operated by Passage Healthcare International.

Residents gave mixed feedback regarding their experiences of living in the centre (file image)

It has 74 beds in total and 73 residents were on site on the day of the inspection in September 2023.

Residents gave mixed feedback regarding their experiences of living in the centre.

Residents said that they received a good quality of care from staff who knew their individual likes and preferences.

However, they also told inspectors that staff were busy, and some had to wait for long periods of time to receive assistance.

Inspectors observed that the supervision and allocation of staff was inadequate and that that there not enough call bells for residents, with some not having any call bell.

Staff told inspectors that some residents were unable to use a call bell due to poor cognition and therefore one was not provided.

Overall, HIQA found that the registered provider did not ensure a safe and appropriate premises in line with its conditions of the registration.

Inspectors also found that the centre was not appropriately resourced to ensure appropriate care delivery in line with residents’ assessed needs.

HIQA noted that systems in place to manage risk was not effective in terms of assessing, responding and managing risks associated with fire safety.

While Lucan Lodge responded to all the issues identified, HIQA inspectors said they were not given adequate assurances that breaches in the urgent compliance plan would be addressed satisfactorily.

In its report HIQA said: “inadequate resources and the poorly defined organisational structure impacted on the quality of the management systems in place to ensure that the service was safe and appropriately monitored.”

Lucan Lodge was found to be homely but the report identified improvements to be made (file image)

The authority gave detailed examples of non-compliance by the provider, Passage Healthcare International, particularly regarding fire evacuation procedures.

Inspectors said they were not assured of the systems in place to provide adequate evacuation aids to assist staff in the event of a fire.

The registered provider was found to operate in breach of its conditions of registration. Changes were made to layout of the centre. These changes were not appropriate and had a negative impact on the safety of residents accommodated at the centre.

Inspectors found poor risk management systems which did not ensure effective oversight of the risk of fire.

The removal of a main central staircase was completed without assessing the risk of the staircase removal to residents’ evacuation in the event of a fire. Other risks are detailed under Regulation 28; Fire Precautions.

They also highlighted poor supervision and oversight of cleaning procedures. The catering, laundry and dementia areas were not clean.

There was no defined system to handover resident information from management team at change of shift.

Poor safeguarding systems as evidence could not be provided that all volunteers were vetted in accordance with the National Vetting Bureau (Children and Vulnerable Persons) Act 2012.

Inspectors found poor oversight of care as evidenced by delayed provision of care to a number of residents who reported and were observed waiting prolonged periods of time to have their care needs met.

Furthermore, one resident who was in receipt of funding for one-to-one care did not have this level of care consistently provided.

Repeated non-compliance in Regulation 23; Governance and Management and Regulation 17; Premises.

HIQA stated that an “urgent action” was issued to the provider, however, the response did not provide adequate assurances for all of the issues raised.

Overall, the report stated that the premises at Lucan Lodge home was bright and homely.

However, inspectors said significant improvements were required in relation to fire precautions.

Action was also required to ensure that the centre was appropriate to the number and needs of the residents.

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