A residential centre for ten adult men and women, some of whom have complex medical needs, run by St John of Gods on a campus based setting in Co Louth was found to be non-compliant in regard to five headings following a report by a HIQA inspector who carried out an unannounced inspection in September 2019.
While the inspector found residents to be happy and well cared for, she reported that 'significant improvements were required in a number of regulations to ensure that a safe, quality service was provided for.'
The centre was found to be non-compliant in regard to governance and management arrangements, fire safety, the premises, residents' records, health care needs and documentation for end of life care.
It was noted that 'Prior to this inspection the provider had identified the need to implement a range of improvements in the centre and some of the improvements were already being addressed.'
The inspector found that some of the care and support needs provided to residents required review to ensure that a safe quality service was being provided. Significant improvements were required in fire safety, health care needs and premises.
While the residents were able to personalise their bedrooms, there was a problem as manual handling equipment was needed and some of the bedrooms were no longer big enough to accommodate this equipment. This meant that some residents could not be supported in their own bedrooms when hoists were being used. The storage of equipment was also a problem as equipment was stored in a number of communal areas on the day of the inspection. One resident and to move out of their bedroom due to a leak in the roof six weeks previously, and this had not been fixed at the time of the inspection.
The back garden was not secured by a boundary wall/hedging in order to ensure residents privacy when they were in the garden.
It was also discovered at a previous inspection that the central heating system was not working. Since then, portable electric heaters were being used to heat the residents' rooms, which was outside the norm. However, steps had been taken to ensure that the centre was kept at the optimal temperature.
Some areas of the centre were dusty. Windows had not been cleaned.
There were no records in the centre to demonstrate whether some clinical equipment had been serviced or maintained in line with the manufacturers' guidelines.
In regard to fire precautions, it was found that fire doors were not maintained/serviced by a competent person. The fire drill conducted at night time had been simulated and the records did not indicate how this drill had been conducted. Therefore the provider had not demonstrated how they could effectively evacuate the centre at night time.
In respect of health care, the report found that 'the processes for documentation, decision making and communication with regard to end of life care required review.' In addition there was no follow up to some recommendations made by health care professionals.
In response, the service providers outlined how they were going to address the issues, including having repairs carried out to bedrooms, improvements to cleaning, reorganisation of storage, as well as improvements in record keeping, treatment plans etc.