East Cork care home had removed call-bells from some residents

Residents in an East Cork nursing home were left waiting for up to 20 minutes for a response from staff, after call-bells were removed from their rooms, an inspector’s report has found.

Inspectors from the Health Information and Quality Authority (Hiqa) said that half the residents living in the Glendonagh Residential Home in Midleton had been assessed as not being able to use call bells, and so had none available to them.

There was no evidence of any alternative way of calling for assistance or alerting staff for these residents, so the residents relied on hourly checks by staff during the night.

A centre spokesperson explained that risk assessments, carried out by the care team, determined that, for some residents, the presence of a call-bell lead posed a greater risk than benefit.

This was due “either due to the inability to use it meaningfully or a risk of entanglement or distress”, but a review of this has been undertaken, and all wall-mounted call-bell leads have been reinstated for residents.

From a review of audits of call-bell response times, there was evidence of delays in response times for up to 20 minutes.

Hiqa said that this continued between two audits, with no improvements seen.

Three residents also told the inspectors that there were delays with response times to their call bells, especially at night. There was no record of a complaint a resident raised with the inspectors, whereby they experienced delays with ‘personal care’ delivery, and had reported it to staff.

Hiqa also found that, while there was a schedule of audits in place at the centre, the repeated poor response times indicated that appropriate action had not been taken between audits.

UNINVITED

The report also found that some residents had no way of alerting staff when another resident entered their bedrooms uninvited, meaning these residents were not appropriately protected.

While the number and skill mix of staff were appropriate, there were not enough care staff rostered after 11.30pm, inspectors said.

The centre spokesperson added that additional audits are now in place, supplemented by unannounced spot checks, and any instance of a response delay exceeding five minutes is flagged and reviewed immediately.

Inspectors also found that a number of allegations and incidents with regard to safeguarding of residents were not appropriately investigated and managed.

Furthermore, a number of allegations or incidents relating to safeguarding had not been notified to the chief inspector as required, which was a repeat finding, and a sudden death in the centre had also not been notified.

Inspectors also noted that there was a gap in the management structure arising from the resignation of both of the clinical nurse managers since the previous inspection.

The provider assured Hiqa that other staff had been redirected to provide continuity during the recruitment process, and a new recruit was now in place.

They added that, following the inspection, a full review of night-time staffing allocations was undertaken, and a revised staffing model was implemented as a result.

The centre was marked not compliant in six areas, substantially compliant in three, and fully compliant in two.