HIQA find issues of non-compliance at Donegal nursing home


Issues of non-compliance have been noted at a Donegal nursing home.

The Health Watchdog has published 31 inspection reports this afternoon with concerns relating to staffing and records identified at Nazareth House in Fahan.
There are currently 48 residents at the facility which provides long-term care including care to people with dementia.

In its latest report, HIQA found that the staffing numbers and skill mix were not adequate to the size and layout of the centre.
While the registered provider informed the inspectors that they were actively recruiting for identified staffing vacancies, additional staffing resources were required to ensure the centre could continue to provide safe and effective care to the residents living there.

Inspectors found that a second nurse at night time was required to ensure resident’s safety was promoted in the event of suspected or confirmed cases of Covid-19.

In addition, housekeeping staff and hours had not been increased in line with the enhanced cleaning schedules that were required due to COVID-19 risks.

In fact, on the day of inspection there were shortages in the housekeeping department due to staff absence.

Inspectors were informed that the household cleaning staff were not always replaced during unplanned absence.

As a result the inspectors were not assured that the housekeeping staffing levels were adequate to ensure that the enhanced cleaning schedules could be maintained.

A review of the multi-task attendant role was also required to ensure staff had the appropriate skills, knowledge and expertise to fulfill the roles safely. A sample of staff files reviewed by the inspectors showed that recruitment practices were safe and met the regulatory requirements.

A review of residents care records found that records were not maintained in line with regulatory requirements.

For example residents’ daily observations were compiled on a communal list that included all the residents in the centre.

This did not ensure that each episode of care was recorded in the resident’s individual file in line with regulatory requirements.

In addition, documentary evidence was not available on the day to show that residents’ assessments were reviewed on a four monthly basis. This was due to an Information Technology (IT) system failure, whereby the electronic system did not automatically renew the date of the assessment on completion. The person in charge addressed this with the IT company on the day and put in adequate controls in place to prevent this issue recurring going forward.

The inspectors were satisfied that this was a recording failure and that these clinical assessments had been completed in a timely manner.
The risk regarding the failure of the electronic system, although identified, had not been appropriately mitigated.

There was no back-up plan for ensuring that care records were appropriately maintained when the electronic IT system failed.

As a result, the inspectors identified gaps in the care records, which included days when the care that residents received could not be accounted for. Furthermore, the daily progress notes maintained by staff nurses in respect of each individual resident were not sufficiently comprehensive and detailed in respect of the care provided to individual residents.

The link to the full report: