The Health Information and Quality Authority raised concerns about the management and staffing levels of Kilcolgan Nursing Home in a report published this week.
An unannounced inspection of Kilcolgan Nursing Home owned by Mowlam Healthcare Unlimited Company was carried out by HIQA on March 5 and 6 of this year.
It has space for 48 residents in total, one regular unit which can accommodate 30 residents, and a dementia specific unit with room for 18 people.
The inspection found the nursing home to be Compliant or Substantially Compliant in 14 areas of regulation.
But the inspector also noted that the home was Not Compliant in a further eight areas concerning staffing, management, and the quality of the premises.
The inspection report notes that residents said that the staff at the home to be “kind and respectful” and that they felt safe there.
However it was added that “Residents told the inspector that they were not happy with how long they had to wait for the nurse call bells to be answered”.
Some residents reported having to wait ten minutes or longer for the bell to be answered. When it was they were often told that the would be assisted as soon as possible.
Multiple residents said that there were not enough staff on duty, and one mentioned a high turnover rate that made it difficult to get familiar staff.
The unannounced inspection was triggered by information received about inadequate management, and a lack of timely care and clinical direction.
A compliance plan had been issued after a previous inspection in August 2017, and two actions from that plan had to be restated after this inspection.
The inspector said that there were significant gaps in the staffing complement, noting that in one example in the week prior there was no staff rostered for the 10am-10pm shift created to address staffing concerns.
In the three weeks prior to this inspection a total of 14 times were noted where “the actual number of staff on duty was less than the planned number of staff required.”
The inspector spoke with several staff members who said they had “raised concerns about the level of staffing in the nursing home with the nurse management team.”
The level of training provided to staff was also deemed insufficient, with one staff member untrained in fire evacuation procedures after several weeks.
Records were also “not securely stored in the centre” with many resident files kept in a container in a communal area that was not securely locked.
Government and management was deemed insufficient for “inadequate resources” to ensure the “effective delivery of care” according to the HIQA inspector.
In addition the quality of the premises was deemed insufficient. On the day of the inspection there was only one person to clean the entire building as the second was off and had not been replaced.
One observations the inspector said that multiple areas of the premises were unclean and poorly maintained.
There were also issue with infection control protocols as the provider “failed to ensure that procedures, consistent with the standards for infection prevention and control published by the Authority were implemented by staff”.
In the areas of individualised care for patients the inspection noted that care plans were not consistently reviewed in consultation with residents and families and there were also issues with the management of challenging patient behaviour.
An urgent compliance plan for the nursing home was put together by HIQA after the inspection.