North Cork nursing takes measures to address Hiqa concerns    

A Mallow nursing home has implemented new checks of fire exits and call bell functionality after concerns were raised about these issues and staffing levels in a recent Hiqa inspection.

Residents of Windmill House Care Centre told the inspectors they enjoyed their days and that there was always something to do, but inspectors found that action was required pertaining to staffing, governance and management, the premises, the management of responsive behaviours, and residents’ rights.

In total, the centre was found compliant in nine areas, substantially compliant in four, and not compliant in two.

Inspectors were not assured that night time staffing levels were appropriate. At the time of inspection, 23 of 39 total residents had been assessed as having maximum to high-care needs, and many required enhanced support for end-of-life care.

The number of nurses was insufficient to monitor residents’ healthcare, administer medication, and supervise care delivery, a finding that was supported by discussions with staff allocated to night duty.

A review of residents’ care plans found that where risk assessments indicated that residents required one-to-one supervision, this was not always provided.

Oversight

Inspectors added that work was required on oversight of infections and ensuring that fire escape routes were kept free from obstruction and the call bell system was working effectively in all bedrooms. Some bells were seen not to be working, meaning residents were unable to call for assistance when required.

A resident living in a twin room did not have access to their en suite facilities, due to another resident’s care requirements and had to travel along two corridors to access a toilet facility. There was a lack of privacy for a number of residents in their own rooms, due to uninvited intrusion from a wandering resident and there were no privacy curtains in one twin room.

The provider told Hiqa after the inspection that weekly call bell audits have been revised to ensure each individual bell is function tested, and that building site exit and fire escape route inspections are now conducted three times daily.

A second staff nurse will be added to the night shift rota, and recruitment is ongoing for additional healthcare assistants, while interim rostering measures have already been implemented to ensure peak evening hours have increased staffing coverage, they added.