Nursing home inspection raises governance concerns

by Louise Doyle

THE State’s health watchdog raised concerns about governance and management and residents’ rights following an unannounced inspection at a Gaoth Dobhair nursing home.

Three inspectors from Health Information and Quality Authority (HIQA) carried out the inspection at Aras Ghaoth Dobhair in April of this year.

Findings were published in recent days.

Inspectors found governance and management non-compliant.

They found the provider’s (Bainistiocht Aras Gaoth Dobhair Cuideachta Faoi Theorainn Rathaiochta) staffing resources were insufficient, posing a serious risk to residents.

“The provider did not ensure that there were sufficient staff on duty each night to carry out fire warden checks throughout the night, as required under Condition 4 of the centre’s current registration certificate. The rosters showed that, on a number of night duty shifts, the additional staff member was not available. This was a significant risk to residents as the provider had been found not compliant with fire precautions on inspections in 2022 and 2023, and their own fire safety risk assessment had identified a high number of red-rated fire risks, which had not been fully addressed at the time of the inspection.”

Inspectors noted that while there was a clear management structure in place, they found that the lines of authority and accountability were not always clearly defined.

The report states: “There were no staff meetings recorded with housekeeping, catering, maintenance or administration staff and no evidence of a structured performance management system in place for these groups of staff. As a result, the inspectors were not assured that this group of staff were sufficiently supported in their role,” states the inspection findings.

Residents’ rights were also found not compliant by the inspectors, who found that the majority of residents in the general unit did not have enough opportunities to engage in meaningful activities that were in line with their interests, preferences and abilities.

“Furthermore, the care records of five residents indicated that they had not been provided with any social care activities in the last three months,” inspection findings state.

Responding, the provider said a number of measures are since in place to address the non-compliances.

Regarding governance and management, regular clinical governance meetings with all departments, documented evidence of meetings and the monitoring of improvement plans is taking place.

Addressing residents’ rights, the provider states: “All residents will be involved in meaningful social activities including participation in scheduled group activities. Residents who are not able to participate with group social activities due to limitations caused by impairment, cognitive and physical deficit are to be brought in as part of the group as well while having alternative activities such as sensory stimulation and bringing different animals for petting therapy.”

A number of additional social activities have been introduced, including a weekly live music session, mass for all residents, gardening and doll therapy.

MANY POSITIVES

There were positives to glean from the inspection report, as the majority of the 16 regulations were found to be compliant or substantially compliant.

Inspectors spoke with many residents during the inspection, and their overall feedback was positive and complimentary of staff and the quality of care in the centre.

“Many residents commented that the food provided in the centre was of good quality and that staff interactions were respectful. Some residents commented that they enjoyed the social outings and were looking forward to future outings.

“The inspectors observed that staff supported residents to take part in various activities in the communal room in the dementia-specific unit.

The residents were mostly in the company of staff in the dementia-specific unit, and group activities such as drawing, gentle chair exercise sessions, quizzes and table games were provided to residents. Some residents from the general unit, who could participate in these activities, were facilitated to attend,” inspection findings state.

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