Major issues with fire safety training and the management of patients who had falls have been identified by the Health Information and Quality Authority (HIQA) at a nursing home in Dundrum.
The inspection of Simpson's Hospital in Ballinteer Road last May found staff were not familiar with fire safety procedures and night staff were not aware there was a delegated person to oversee these.
Records of fire drills carried out every six months showed that "in some cases one staff member had taken part in the drill and in another, only the catering staff took part".
A small number of residents smoked, but "actions to prevent the risks from smoking were not consistently outlined".
In the cases of patient falls at the nursing home, the HIQA inspector expressed concern "that the practices in relation to the management of falls put residents at risk".
Where falls had occurred "there was inconsistent evidence that neurological observations were carried out" afterwards.
Residents were not routinely re-assessed after such an accident, and their care plans were not updated after each fall.
The inspector drew particular attention to "a resident who had multiple falls and whose care plans did not outline how to protect the resident and prevent more falls occurring".
The report said that while there were grab-rails and handrails in place along with safe flooring, "improvements in the overall management of falls was required".
A small number of patients with challenging behaviour did not have a care plan which identified triggers for this behaviour and strategies to manage it.
There were a variety of activities such as exercise classes, board games, arts and crafts and bingo at the nursing home.
The inspector found, however, that the social care of residents who were unwilling or unable to take part in activities at the nursing home "required improvement".
Care plans for dementia patients "did not clearly outline the residents' likes, dislikes and interests".
The HIQA report, published yesterday, also includes a response from the nursing home on July 23.
Management said they had reviewed fire safety procedures with both staff and external expert consultants, staff were being provided with extra training and scheduled fire drills were now under way.
All falls would now be reviewed monthly at the clinical governance meeting and residents would be routinely re-assessed after a fall with their care plans updated accordingly.
Other measures such as bed alarms, floor crash mats and assessment by a GP and physiotherapist after a fall would also be undertaken.
The hospital's activity co-ordinator was reviewing the social care needs of residents with cognitive impairment.
The home said residents' care plans would be reviewed and updated according to the schedule given to the inspector and the complaints policy was reviewed.