Cork city nursing home criticised for practice of residents going to rooms at 4.30pm for the night

A HSE-managed nursing home on the south side of Cork city has been criticised for the practice of residents going to their rooms at 4.30pm and staying there until bedtime.

Farranlea Road Community Nursing Unit was issued several non-compliances in a recent HIQA inspection, a large percentage of which were regarding “inadequate” staffing.

The inspector noted that when they arrived at the centre for the unannounced inspection “the majority of residents were in their bedrooms and the living and dining rooms were almost empty.

“Discussions with residents, visitors and staff indicated that it was common practice in the centre for residents to return to their room at 4.30 pm, have their supper in their rooms and stay there for the night,” the inspector wrote, adding: “This did not offer residents choice and was an institutionalised practice.”

While there was ample staff available in the evening up until 8pm, after this time the staffing “was found to be inadequate.”

The inspector observed residents waiting for care delivery and residents calling for assistance and staff not being available to them, and the nurse was interrupted from medication administration numerous times.

Staff indicated that they were responsible for assisting a large proportion of residents with their nutrition, hydration, continence, and mobility and it was “exceptionally busy and difficult to attend to residents care and assist residents at this time of night.”

The inspector also observed that a number of residents did not have call bells available in close proximity to them, leaving them calling out for assistance.

This inadequate staffing led to residents waiting for care, delays in the administration of medications and inadequate supervision of residents in their bedrooms, and this was also a finding on the previous inspection and had not been adequately addressed by the provider.

Another repeat finding from the previous inspection was that significant action was required in the area of training and staff development.

Records demonstrated significant gaps in training in safeguarding vulnerable adults, managing responsive behaviour, cardiopulmonary resuscitation and manual handling, all of which were listed as mandatory training in the centre’s policy.

The centre provided significant detail as to how they were going to achieve compliant in the areas of staffing, training, and residents’ rights.

They explained: 

“All vacant positions have been identified and escalated for derogation. Currently all staff are being offered overtime and agency staff are also being utilised to address these staffing deficits.”

Rosters are now reviewed daily, additional agency staff have been introduced for twilight cover, and the hiring of additional staff in senior roles is being considered.

A system has been introduced for training records to be maintained and monitored through a monthly audit, and several staff members have already undertaken training, with the centre pledging to have all mandatory trainings completed by the end of August.

Multiple surveys of residents have been completed, and a residents meeting has taken place, with feedback from these to be discussed and implemented where possible.