Monday 22 July 2019

HIQA report finds ‘substantial improvement’ at Kanturk Community Hospital

However, health watchdog says some areas still need more work

Bill Browne

Things are moving in the right direction, but more work needs to be done. If the latest Health Information and Quality Authority (HIQA) report into Kanturk Community Hospital took the form of a report card, the above statement could well be its final conclusion.

The unannounced inspection by HIQA officials on February 20 was a follow up to what the authority described as "the poor findings" of four previous reports, the most recent of which was published last February.

That was sharply critical of the facility, with inspectors writing its findings had "demonstrated that the HSE had failed to address the deficits in governance and management" identified during previous inspections. 

The report noted that "an absence of an effective system of governance was evident" in the failure to progress remedial works required to address fire safety risks, a failure to improve the privacy and dignity of residents and "a lack of involvement of and oversight by senior managers in plans to address both issues." 

It went on to say that despite three inspections with findings of poor regulatory compliance since January 2018, the HSE had "failed to implement their own compliance plan and to make necessary improvements". 

Examples cited included: the failure to appoint a director of nursing; that long-term residents continued to be accommodated in situations that "adversely impacted their daily quality of life, privacy and dignity; that personnel records review did not contain Garda vetting discloses and that no system to determine staff training to ensure the protection of residents was "understood and implemented." 

"In conclusion, the findings were that the HSE had failed to take the necessary action to strengthen the governance and management of this centre for the purpose of improving the quality of life for residents and supporting staff on the ground in striving to achieve greater regulatory compliance." 

The report also found shortcomings in areas including staff training, that the premises was "not fit for purpose" for the number of patients living there and that individual assessment and care plans "were not comprehensively completed or updated in a timely manner." 

HIQA conceded the findings from the most recent inspection had shown "a number of initiatives were in process to address the deficits in governance and management previously identified."

It said that measures to "ensure the service (at the hospital) was safe, appropriate, consistent and effectively monitored" included: the appointment of a person in charge, the establishment of monthly 'Quality Patient Safety' committee meetings and the setting up of local weekly governance and management meetings.

Other measures included an annual review of the service, the completion of fire safety works, a review of the staff training matrix, the appointment of a practice development nurse and putting in place vetting procedures for all staff.

However, while the report noted "substantial improvement", HIQA said the HSE needed to take further action to "strengthen the governance and management of this centre for the purpose of improving the quality of care of residents".

"Areas for improvement that had been on previous inspections persisted in relation to personal accommodation, storage of personal possessions, accessibility to shower and toilet facilities, end of life care, food and nutrition, infections prevention and control, fire precautions, individual assessment and care planning and residents rights," concluded the report. 

The full report and an attached compliance plan drawn up by HIQA and the HSE can be viewed in full at