Wednesday 17 July 2019

Inspectors raise fire evacuation concern at Tubber nursing home

Paul Deering

HIQA has expressed concern about evacuation in the the event of a fire at a family run nursing home in Tubbercurry

An inspection was carried out on February 4th last at Bailey's Nursing Home, operating since 1995 and which caters for 41 residents, men and women in 10 single rooms, 14 double rooms and one room that accommodates three residents.

In its report HIQA say that the inspectors were not assured that the three staff on night duty would be able to undertake a safe and effective evacuation of the building taking into account the compartment that accommodated 12 residents, the overall high dependency of the residents accommodated and the proportion who had a diagnosis of dementia.

The report states the fire safety arrangements required comprehensive review as the inspectors also found that the registered provider had not taken adequate precautions to ensure that residents and staff were protected from fire risks and that appropriate systems were in place to ensure the safe and effective evacuation of all residents in an emergency.

Adequate arrangements had not been made for reviewing fire precautions to ensure residents, staff and visitors were appropriately protected, it stated.

The inspectors judged that exercises that were limited to one room required review in order to to ensure staff had adequate knowledge on how to evacuate the entire centre, particularly the compartment where 12 residents are accommodated.

The inspectors found that staff had not received adequate training to prepare them for the evacuation of the centre or to move residents appropriately to a safe area. For example, no drill had been completed from the largest compartment which contained 12 residents the majority of whom were assessed as having high or maximum care needs, using the night time staffing levels to assess if the equipment/resources available were adequate.

In addition, the inspectors found that suitable arrangements had not been made for the safe placement of residents and for their evacuation if necessary. For example, at fire exits there were few signs to direct people to the fire assembly point located in the car park. Some fire exits were obstructed with plant pots externally and by furniture internally. The inspectors observed that there were a number of areas where there were no fire plans displayed, Where fire plans were displayed the exact location of the assembly point was not clear.

The report goes on to say that the inspectors saw that the level of privacy for many residents was compromised by the size and layout of their bedrooms and inadequate screening around beds.

Some bedrooms were provided with single wardrobes and bedside lockers which did not enable residents to keep a reasonable amount of personal clothing or possessions in the centre. This meant that residents did not have access to or control over their personal possessions.

The availability of one television in rooms meant that residents could not freely watch television programmes of their choice without intruding on others. The lack of space in the double rooms to the front of the building and the triple room also meant that residents could not have a comfortable chair by their bed if they wished to sit in their room quietly.

The inspectors also had concern regarding the deployment of staff at meal times. The inspectors observed that there was no nurse available in the dining room during most of the lunchtime period when many residents requiring modified diets or who were at risk of choking were having their meal.

The report states that the centre was undergoing major refurbishment to ensure that appropriate space and adequate privacy will be available to residents and that non-compliances identified in previous reports are addressed.

The building has a number of deficits that compromise the privacy of residents and detract from how staff can promote privacy and protect dignity.

These issues include inadequate space, screening that does not fully protect privacy and inadequate storage in some double rooms and the multiple-occupancy room.

These matters are being addressed by the phased building programme that is now underway. Phase one is now complete. This was inspected and was found to have been completed to a high standard.

The bedrooms met the required space standards and were attractively furnished and well equipped with suitable beds, armchairs and storage.

In response the nursing home stated that two days following the inspection a fire training consultant carried out a full evacuation of the 12 bed compartment and the 3 double rooms to the front of the building using three night staff.

A fire risk assessment was carried out and all means of escape had been cleared

Extra Signs were erected for guidance to the assembly point.

The particular exit which has been described as being obstructed with plant pots is incorrect as these pots are placed either side of the door and do not impede the exit and are purely here for the resident pleasure. Fire plans are evenly placed and displayed throughout the building and assembly points were clearly indicated on the day of inspection.

Regarding meal times, the home stated that a nurse was present at all meal times and the majority of its care staff had been with them for many years and had a vast knowledge of care and personally knew all the residents. The majority of the staff had training in CRP and were more than competent in the supervision of meal times.

All staff present in the dining room during lunch time on the day of inspection had high mix skill of experience in cardiopulmonary resuscitation and familiar with all residents' needs and action to be taken in the event of an incident such as choking.

On the issue of privacy the home said screens wre provided in all shared accommodation to provide privacy to residents.

"We also provide private areas and a visitors' room to accommodate residents so that they may have conversations in private, if they wish.

"All rooms in the centre are fitted with a television in accordance with residents' wishes. The Inspectors' views in relation to more than one television in any room is not understood by strict reference to the Regulations or indeed the wishes of the residents.

"All residents have access to sitting rooms throughout the centre which also have televisions if a resident requests to watch specific programmes.

"The rooms referenced as having lack of space have chairs provided. Should a resident require a different type of chair this is accommodated, strictly in accordance with their wishes.

"Lockers provided have keys so residents have access to and control over their personal possessions which was commended by Inspectors on the day of Inspection.

"Any residents that request more space for personal items are accommodated

All rooms are equipped with a television. No complaints have been received to date on access to televisions by residents.

Alternative day rooms are also equipped with televisions."

Residents described the centre as a safe and comfortable place to live. They told inspectors that staff were kind and considerate to them and attended to their needs promptly when they requested help.

Call bells were answered quickly day and night and when they had particular requests these were met in a timely way.

Residents said they had meetings where they were able to express their opinions about the service. They felt their views were valued and taken in to account in the organisation of the service.

The catering and food was described as good and the menu was varied.

Sligo Champion