Inspectors reviewed a selection of resident's records and spoke with staff that developed and used them. Prior to admission an assessment was carried out to ensure that the resident's needs could be met in the centre. When residents were admitted a more detailed assessment was completed by nursing staff and a care plan was developed. Risk assessments were completed in key areas such as falls risk, nutritional risks, pressure sore risk, responsive behaviours and moving and handling risks. Clear risk management plans were in place which supported resident autonomy and promoted self care abilities and independence. Care plans and risk assessments were agreed with the resident and their family Care plans were seen to provide clear information to staff providing care and support to residents.
As the refurbishment programme continues, all bedroom doors are now a purple colour with bathroom doors and en-suites a blue colour, general doors / communal rooms are a green colour and areas that have restrictive access the doors are a red colour. More signs and picture signs will be placed around the nursinghome detailing the specific area or room e.g. bathroom. Clocks will be purchased and placed in bedrooms. In the new year calendars will be purchased and placed in bedrooms also. As per our plans submitted to HIQA, the exterior garden and landscaping will commence upon
There were adequate resources allocated to the delivery of the service in terms of equipment, catering, household and maintenance. Care and nursing staff vacancies were filled with temporary agency staff to implement the planned roster. Staff allocations and provision to meet the needs of residents required review, as the centre is currently recruiting to the staff team. Inspectors saw some examples of staff engaging with residents in a person centred and respectful manner.
Ros Aoibhinn is located on the outskirts of Bunclody. The centre can accommodate 30 residents in four single and 13 twin rooms. There are two floors and most of the residents are accommodated on the ground floor, where communal accommodation includes two sitting rooms, a dining room and a conservatory. Accommodation on the first floor comprises one single and three twin bedrooms and is accessible by a stair lift. Ros Aoibhinn provides 24-hour nursing care to both male and female residents over 18 years of age. Long-term care, convalescent and respite care is provided to those who meet the criteria for admission.
Inspectors observed positive interactions between staff and residents over the course of the inspection. Staff had a good knowledge of residents' health and support needs, as well as their likes and dislikes. Nursing staff were available at all times, and there were sufficient staff to meet the needs of residents including household staff. At the time of this inspection, staffing levels were in keeping with the assessed needs of residents and the size and layout of the centre.
Maryfield NursingHome aims to provide full time nursing care in a supportive and stimulating environment for residents over the age of 18. General nursing care, dementia care, palliative and end of life care are all available in the nursinghome. It is situated in Chapelizod with many amenities nearby. These include restaurants, public houses, shops and public parks. It is a purpose built nursinghome with 69 single ensuite bedrooms. There are facilities for recreation onsite; including activity rooms, a library and pleasant grounds which include secure internal courtyards. There are activities taking place in the centre that link with the community, for example a choir and a knitting group. There is also daily roman catholic mass.
Residents’ religious and political rights were facilitated. Mass was celebrated weekly in the main dayroom and relayed to televisions in residents bedrooms for those who preferred to stay in their rooms. Residents recited the rosary each evening and the ministers of the Eucharist visited weekly. The person in charge advised that all residents were currently Roman Catholic but that all residents of varying religious beliefs were facilitated as required. She also told inspectors that residents were facilitated to vote and explained that residents had been facilitated to vote in-house during the recent general election.
protected. Improvements had been made to ensure that all residents had a choice of appropriate and stimulating activities to meet their needs and preferences. A social care leader co-ordinated the activity and communication sessions. In addition, residents' meetings were held which provided opportunities for residents to become involved in the centre. Residents’ civil and religious rights were respected. Residents confirmed that they had been offered the opportunity to vote at election time. In- house polling was available. Mass was celebrated on a weekly basis in the spacious oratory, communion was available on Sundays and other ministers visited as
Castleturvin NursingHome is registered to provide care for 42 residents. It is purpose built and located in a rural setting a short drive from the town of Athenry. The building was laid out over two storeys with lift access provided to the first floor. Accommodation is provided in 22 single and 10 double rooms all of which have ensuite facilities. There are communal areas on both floors. Externally there are extensive grounds with a large garden area that is accessible to residents. Many rooms have doors that lead directly onto the garden.Residents that have high, medium or low care needs are accommodated and care is provided on a long or short term basis.
The nursinghome had a low turnover of staff and operates a recruitment policy and selection process for prospective employees and work experience students, which is aimed at ensuring that staff are suitable to care and support residents. This includes the completion of Garda Vetting which was seen completed in a sample of the staff files examined. The provider representative and person in charge told inspectors that all staff had a disclosure of Garda Vetting. Staff recruitment and
The person in charge was an experienced nurse manager and had worked full-time in the centre since 2006. She had been working in the centre as a manager since 2009 and as the person in charge since 2015. During the two days of the inspection, the person in charge demonstrated good knowledge of the legislation and of her statutory responsibilities. She was clear in her role and responsibilities as person in charge and displayed a strong commitment towards providing a person-centred, high-quality service. She had committed to continued professional development and she had regularly attended relevant education and training sessions, including a post-graduate management training course. The inspector found that she was well known to all residents and staff. Residents and relatives all identified her as the person who had responsibility and accountability for the service and said she was very approachable. The person in charge was also described by a number of staff as a hands on and very approachable manager, who was always supportive of staff. There were arrangements for the assistant director of nursing or the staff nurse on duty to replace the person in charge for short periods including the evenings, weekends and during annual leave periods.
The centre rated themselves as substantially compliant in this outcome; and detailed some actions they were taking to come into compliance. In the centre's last inspection in August 2017, this outcome was judged as a moderately non compliant. The actions identified included re-writing care plans and conducting monthly audits on care plans. The inspector found the care planning process had improved. Care plans were recorded on a main sheet and when they were reviewed the review date was recorded, and the care plan updated. The assistant director of nursing (ADON) was completing monthly audits on samples of care plans. The majority of care plans reviewed had been reviewed every four months or sooner if the residents condition changed. Some gaps in care planning were identified in the in restrictive practices, however this will be addressed in Outcome 2. Care plans were clear and contained person-centered language and
There was a person in charge of the centre. The person in charge was supported by an assistant director of nursing and staff team to meet the needs of residents. The provider supported the person in charge and was actively engaged in the day to day running of the centre. The management team were committed to provide a good quality service. Residents, their relatives and staff who spoke with inspectors said that the person in charge and the providers were always available and put the residents at the centre of everything and were very supportive of families and of staff. Residents and families spoken with said they were kept up to date on all aspects concerning their care. The person in charge and the providers reviewed the service regarding management/operational issues however this was not done on a formal basis and there were no minutes available of governance/management meetings, action plans or progress made.
manager. The role of assistant director of nursing was no longer in existence. While the management arrangements put in place at the last inspection had sustained certain improvements in the centre, inspectors were concerned about the ongoing sustainability of these improvements due to current issues with staffing. The person in charge was currently rostered to work most shifts as a staff nurse in the centre in order to deal with the nursing vacancies. The management structure was currently not in full effect due to the post of person in charge not being a full time role, to ensure the effective
During the last inspection inspectors were not satisfied that the skill mix of staff at certain times of the day was sufficient to ensure that residents' needs were being met, as one nurse was on duty to support 28 residents. The inspector was not assured during this inspection that the rostered nursing hours were sufficient. The nursing hours as indicated on the rosters did not reflect the number of whole time equivalent nurses as detailed in the statement of purpose. The inspector was provided with an analysis of the staffing levels in the centre based on the dependency levels of the current residents. However this analysis indicated that there were two nurses on duty every day from 8am to 12pm, but a review of the staff roster indicated that over a 4 week period this 8am- 12pm shift was only filled or rostered to be filled four times.
Dealgan House is a purpose built nursinghome located close to Dundalk town. The designated centre provides 24 hour nursing care to 84 residents over 18 years of age, male and female, who require long term as well as short stay care such as respite and convalescence. Accommodation is provided on the ground floor in 82 single bedrooms and one twin bedroom. The centre is decorated and furnished to a high standard throughout. The centre is divided in three areas: the main part of the nursinghome has 52 beds, an enclosed garden and it's own function room and dining area, as well as an Oratory. A recent extension in 2016 has added the Tain Suite which has 15 bedrooms, sitting and dining facilities and a kitchenette, and the Sonas Suite, a Memory Loss Unit with 17 bedrooms and all the required facilities. Both suites operate as self-contained households led by a Homemaker. Residents of the Sonas Suite have access to the sensory garden in which they can relax or
A comprehensive assessment of the health and social care needs of residents who had dementia took place prior to admission. The person in charge carried out the pre- admission assessments to ensure that the layout and staffing could accommodate the particular needs of those with dementia. Appropriate care plans were seen to be in place which were reviewed four-monthly. General practitioner (GP) services were available to residents. The pharmacist visited the centre and supplied medicines as prescribed by the GP. Allied health care services such as physiotherapy, speech and language therapy (SALT) and dietitian were consulted. Documentation from these personnel confirmed that they visited residents in the centre. Weekly physiotherapy sessions were available privately and the physiotherapist was seen to be attending to residents during the inspection. Chiropody and hairdressing services were also accessed on a private basis. Referrals and follow-up appointments with consultants were facilitated for assessment of residents with dementia. Clinical assessments such as skin integrity, mobility, falls, nutrition and cognitive assessment were completed. The inspector spoke with a number of staff who was found to be familiar with residents' nutrition needs, special diets, likes and dislikes. Modified diets looked appetising. Food choices were impressive, residents had a daily menu and fresh home baking was presented daily.
There was a clear complaints procedure in place and information in relation to the complaints procedure was available in the resident's guide and was displayed in the centre's reception area. The person in charge maintained a log of formal complaints that were received in the centre however there was no log of informal complaints received by staff on the units and no record of how these had been managed. Residents and families who spoke with the inspectors were aware that there was a complaints process in place but a number of those spoken with were not aware of who was responsible for managing complaints in the centre. Residents and families told the inspectors that when they raised issues with staff on the units the issues had been dealt with at the time but that the same problems would recur again and they had to report the issue a second or third time. Records showed that one resident council meeting had been held in the centre in January 2018, however these meetings should have been held every quarter in line with the centre’s