Tuesday 16 January 2018

Nursing homes need to improve quality of life for residents - Hiqa

Hiqa director of regulation Mary Dunnion
Hiqa director of regulation Mary Dunnion
Eilish O'Regan

Eilish O'Regan

Nursing homes generated a sharp rise in complaints last year - most of which involved quality and safety of care as well as low staffing levels.

The 609 "unsolicited" tip-offs were made to the patient safety watchdog, the Health Information and Quality Authority (Hiqa), according to its nursing homes annual overview.

The report, based on the findings of 798 inspections of public and private nursing homes, said that while there was now good compliance with making these facilities safe, there needed to be more emphasis on improving quality of life for residents.

"We asked providers to take 5,864 corrective actions to address non-compliances," said director of regulation Mary Dunnion.

Issues of concern included:

  • Lack of privacy and dignity for residents still living in nightingale wards.
  • Not enough staffing or inadequate skill-mix.
  • Serving a main meal too early in the evening.
  • Lack of proper quality of care for residents who are dying.

In six centres a resident at nutritional risk did not have a care plan. In another centre a resident with special dietary needs was not provided with appropriate food and drink because the advice from a speech and language therapist about what the patient could swallow had not been communicated to catering staff.

While meals were mostly served to suit residents, there was a pattern in some centres where staff went off duty at 5.30pm and the evening meal was served too early.

In one case it was served as early as 4.15pm and in another the residents had to have their breakfast before 8am.

Referring to end-of-life care, the report said it was generally appropriate and safe. However, in some cases staff lacked the skills and competence to engage residents about their preferences and wishes at this time.

Inspectors looked specifically at how residents' clothing, personal property and possessions were cared for in 324 visits. The report found nearly seven in 10 centres were compliant. Among those that needed corrective action, the majority of problems involved lack of space for safe storage of personal possessions and also incidents were clothing went missing.

Meanwhile, Tusla, the Child and Family Agency, announced yesterday it had reached agreement with social workers to begin the roll-out of a nationwide 24-hour duty service to respond to children in crisis.

It followed a separate report by Hiqa on child protection services in north Dublin which found delays in notifying gardaí about suspected cases of physical abuse.

The February report found the impact of long-term harm and neglect on children's wellbeing was not fully considered by staff.

Some families were being referred back to the service again, but there was no accurate data to signal patterns of recurring welfare issues. The service also suffered from under-staffing and the allocation of complex cases to inexperienced social workers.

In response, Tusla said the report acknowledged children in most need were prioritised. The earlier notification to gardaí was now in place and more social workers were also being recruited, it added.

Irish Independent

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