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HIQA report into St John’s Hospital in Enniscorthy finds facility is compliant but room for improvement


St John's hospital

St John's hospital

St John's hospital


AN report into St John’s Community Hospital in Enniscorthy found the facility to be compliant or substantially compliant in relation to 19 out of 20 different categories for which it was inspected earlier this year.

A finding of ‘substantially compliant’ means the service provider or person in charge has generally met the requirements of the specific regulation but some action is required to be fully compliant. Such findings have a risk rating of yellow which HIQA said is low risk.

However, the report also noted that more social interaction should take place between residents and staff but that the interactions that do take place are “positive and kind”.

The hospital is a residential care unit operated by the HSE and the report by HIQA (Health Information and Quality) into the inspection carried out at the Munster Hill facility in February, has recently been published.

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There were 93 residents in the hospital on the date of the inspection which saw the inspectors speak with some of them and the people visiting them to find our what their personal experiences were.

The inspectors also spoke with staff and management to find out how they plan, deliver and monitor the care and support services that are provided to people who live in the centre. The inspection was lead by John Greaney with support from Mary Veale.

Overall, the inspectors found the residents to be happy living in the centre and they were informed by them that they are well cared for, felt safe and that the staff were kind.

"Residents said they enjoyed the food and the choices available to them,” said the inspectors in their report.

“One resident told inspectors that staff were very attentive and that when they rang the call bell they were not waiting a long time for a member of staff to respond,” they added. “Staff were observed interacting with and assisting residents in a friendly and respectful manner.”

While there were many positive observations made by the inspectors they also noted room for improvement.

They said they observed cluttered linen rooms and store rooms and that they required rearranging to improve work efficiency.

“Store rooms were inappropriately stocked with linen, toiletries and incontinence wear posing a risk of cross contamination,” they said.

“The sluice rooms were cluttered with multiple commodes and shower chairs,” they added.

“Taps require replacing in a hand wash sink in the housekeeping room on Beech ward in order to ensure safe work practices and reduce the risks of cross contamination in this high-risk area.”

The inspectors noted that commodes were routinely shared and that while a decontamination sticker was in place for most of the commodes a small number of them did not have up to date decontamination stickers.

“It was difficult to determine when and by whom the commodes were cleaned,” said the inspectors.

In terms of quality of care family members who spoke to the inspectors during their visit expressed satisfaction with the care and were complimentary of the staff communication during the pandemic.

The two-day inspection was unannounced and was orchestrated in part to follow-up on a previous inspection compliance plan.

“At the time of the inspection there were 11 vacant beds and the centre was emerging from an outbreak of Covid-19,” noted the inspectors.

They noted that the governance structure was comprised of a general manager and a person in charge who reported to the general manager. The person in charge had responsibility for the day-to-day operations of the centre. She was supported in her role by two assistant directors of nursing (ADONs). the ADONs took charge of the centre in the absence of the person in charge.

The inspectors found “good practices in the management of the staffing levels” in the hospital and rosters showed agency staff were employed on a long term basis to fill vacant posts. They also noted there was an ongoing and comprehensive training programme in place for all staff and all clinical staff had completed safeguarding, manual handling, and infection control training.

However, the inspectors said gaps were identified in training relating to managing challenging behaviour.

“While there was evidence of ongoing improvements, such as reducing bed numbers to enhance facilities for end of life residents and their relatives and improved storage space, management systems were not consistently effective in ensuring the service was safe, consistent and effectively monitored,” said the inspectors in the report.

The only area in which the facility was found to be non-compliant was in relation to the premises with the inspectors noting that: “As found on previous inspections the premises did not conform to the matters listed in Schedule 6 of the Health Act 2007(Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 and did not fully meet the needs of residents as set out in the statement of purpose.”

In particular the inspectors noted there was inadequate communal space in both the Oak and Elm units and the available communal space in those units was not in line with 2016 National Standards for Residential Settings for Older People in Ireland which recommends four metres squared per resident residing in the area.

On the day of the inspection the quiet room in the Oak Unit was being used as a bedroom and the inspectors said that further limited the communal space available to residents.

"A review was required of available storage space to ensure that all available space was optimised with a view to re-purposing some rooms,” noted the inspectors, who also said many bedrooms didn’t contain any memorabilia or photographs and that they lacked personalisation.

However, in a wide range of areas the hospital was found to be substantially compliant including: risk management; infection control; fire precautions; individual assessment and care plan; protection; residents’ rights; training and staff development; governance and management.

Areas where the hospital was found to be compliant with regulations included: persons in charge; staffing; records; notification of incidents; complaints procedure; written policies and procedures; visits; personal possessions; end of life; health care, and managing behaviour that is challenging.

In response to the report findings and in particular with regard to the non-compliance finding relating to the premises the management of the hospital said work has commenced to re-purpose two bed rooms on the Oak and Elm units to dining rooms to increase communal space in line with 2016 National Standards for Residential Settings for Older people in Ireland with the work due to be completed imminently.