Residents of nursing unit in Cork dressed in night attire too early

Ballincollig Community Nursing Unit has undertaken a review of evening routines after residents were observed to be wearing their pyjamas for hours before going to bed.

A HIQA report into the centre notes that residents were complimentary of the food, kindness of staff, resident’s meetings, and activities on offer, but the report did note some areas of concern.

The centre was marked compliant in 10 areas, substantially compliant in five and not compliant in one.

“The inspectors were informed by a number of residents that the temperature in the centre was too hot and staff were unable to control the temperature. Inspectors also noted the centre was noticeably very warm on both days of the inspection,” the report noted.

A number of residents were living with a cognitive impairment and were unable to fully express their opinions to the inspectors — many of them were seen to be in night attire very early in the evening.

This led to a finding of not compliant in the area of resident’s rights, with the report noting: “Residents who were sitting in the communal rooms, attending activities in the evening, were already dressed in their night attire, which did not support their dignity.

“It had become a practice to get residents into their nightwear after the tea time meal from 5pm onwards, despite the fact that many of these residents did not actually go to bed until after 9pm.

“The inspectors noted, as the day rooms were very warm, none of the residents wore dressing gowns and were sat in mixed gender rooms which also accommodated visitors,” saying that this “did not protect the privacy and dignity of residents.”

Also noted, under this finding, was residents “not accommodated in appropriate communal spaces”, with the report explaining: “Many were positioned in chairs near the nurse’s station which did not provide them with a homely environment.”

A number of residents told the inspectors how they requested single rooms and were on a waiting list for these. They told inspectors they found the shared rooms were noisy and that it impacted their sleep and comfort.

The inspectors observed that while some residents had access to call bells, some residents did not. Residents and relatives told the inspectors that staff were generally quick to answer their call bells but at times particularly in the evening there could be delays.

Staffing during the day was seen to be sufficient, but in one unit, staffing was reduced in the evening to one nurse and one care staff from 8pm.

The nurse at this time was administering nighttime medications which left only one care staff to provide care to residents, a number of whom required the assistance of two staff.

The care staff was also responsible for supervising the day room and for answering call bells, leaving them “extremely busy” and leading to delays with some call bells.

The provider assured the centre that a review has been undertaken into evening arrangements, and that they will ensure that staff are advised that residents are not to be changed into night wear until they request to go to bed, and that seating arrangements have been improved.

They added that a call bell audit is to be completed daily, temperatures are to be reviewed daily, and additional evening staff assigned.