Outline how you are going to come into compliance with Regulation 17: Premises: The walkway around the lake was slippery when wet. This is being power –hosed and rendered safe again. Additional stone has been laid at the back left of the building, this has rendered the pathway smooth and easy to traverse.
Handover arrangements had been revised to ensure that staff were available to attend to residents at shift changeovers. Staffing levels especially the nursing levels, which were the same for day and night duty needed to be reviewed. Alternative arrangements for the supervision of staff had been implemented but inspectors found the arrangements in place for the supervision of staff were inadequate. A major non-compliance was merited in relation to Outcome 2 Governance and Management because inspectors found evidence that the management structure was not sufficiently robust to assure the quality and safety of the service. The systems in place to review and monitor the quality of care were not adequate and seven of the 16 actions required from the last two inspections were still outstanding.
Outline how you are going to come into compliance with Regulation 13: End of life: All long-term residents in Laurel LodgeNursingHome have an existing mandatory end of life care plan which details their needs and how we intend to meet them however after the recent transfer of documentation from paper and hard copy to digital the initial use of frame works and templates has ceased and the process, which had begun of
Outline how you are going to come into compliance with Regulation 17: Premises: The provider is in the process of planning a 25-bedroomed extension at rear of building which will be incorporated into current building, and a detailed refurbishment of our existing 52 rooms will also be completed to provide all rooms with a separate en-suite. The living environment will be much more stimulating and enjoyable for our residents and their families. All of our residents will be involved in the decision-making process and will be kept up to date as the plan progresses. Meantime areas in main bathrooms ill have repairs completed with regard to tiling. The doors on some rooms will be refurbished to enhance their appearance. Residents will be helped to have a sense of • more ownership of their personal space e.g. some of our residents have asked to have their rooms re painted. We will ensure that colour schemes are appropriate to enhance their sense of belonging and enjoyment.
Residents' well-being and quality of life was enhanced and promoted through on- going review and assessment using recognised nursing assessment tools and care plans that were person-centred and assessment focused. Practices such as the use of restraint were in line with the National policy and best practice. Residents visitors were welcomed into their home.
Staff Nurses were notified via memo regarding the importance of ensuring that the controlled drug check is completed twice daily on the 17/9/18. The controlled drug check book was reviewed and updated to ensure that it is very clear and concise what needs to be checked and signed by the registered nurses. This is signed off by the registered provider or the person in charge. This action was completed on the 17/9/18 and it is also planned that this issue will again be addressed at the scheduled drug training taking place on the 8/10/18 and the 11/10/18, and will continue to be highlighted at Staff Nurse meetings.
Supervision continues to be provided by CNM’s and Team Leaders, and supported by the ADON and PIC. Supernumerary hours are allocated to the people in these roles to ensure supervision is available on a consistent basis. Feedback is provided to supervisors and staff across all floors to ensure a consistent approach is taken. The PIC meets with the CNMs and Team Leaders every two weeks to provide guidance and agree actions. Every 3 months, the PIC completes a night check including walk around of all units, checking on each resident as well as the check list on each floor. This was last completed on 12th October2018.
The person in charge promoted professional development for staff. Training was tailored to meet residents’ needs. Staff told the inspector they had received a broad range of training which included dementia care and managing responsive behaviours. A training plan was in place for 2018 and this included additional training in fire management, infection control, falls prevention as well as dementia care.
This was an unannounced inspection to monitor ongoing compliance with the Regulations. The inspector followed up on progress with completion of actions from the last inspection in April 2018. There were non compliances with four regulations found on the last inspection and improvements to bring medicine management into compliance were satisfactorily implemented. Refurbishment work was ongoing to upgrade the first floor of the premises. Non compliance found during the last inspection regarding provision of opportunities for residents to participate in meaningful activities to met their interests and capabilities was not satisfactorily addressed. These non-compliances were found again on this inspection and are restated in the compliance plan with this report. The inspector followed up on information in notifications and unsolicited information received by the Office of the Chief Inspector since the last inspection in April 2018.
The training records for all staff were reviewed and showed that a wide range of training was provided for staff including training in areas such as dementia and managing responsive behaviours. The inspector noted that the dementia training included an item called 'a take home message' which was a change that the staff member was going to undertake as a result of the training. This was then reviewed a week later to check progress. Staff spoken with told the inspector how valuable they found this element of training.
The designated centre provides care and support to meet the needs of both male and female older persons. The philosophy of care is to provide dignity and respect to all residents at all times, whilst incorporating both personal and family centred care. It is situated in a residential area in Lucan. Twenty-four hour nursing care is provided to a maximum number of 74 residents spread over 3 floors. It provides nursing care to dependent residents over 18 years of age. The homecare model of care is
Education and training on dementia care, responsive behaviours and statutory topics such as fire safety and adult protection had been provided to ensure that all staff were appropriately skilled to meet the diverse care needs of residents. Staff were effectively supervised by the person in charge and nursing staff were observed to be available to provide advice and guidance throughout the inspection. As described throughout this report staff engaged positively with residents and to their requests for assistance. Staff the inspector talked to were enthusiastic about their work and said they enjoyed the company of residents and ensured they made a positive contribution to residents’ quality of life each day. They said they were familiar with the standards of care expected and worked hard to achieve high standards every day.
Cherryfield Lodge is situated in Ranelagh, Dublin 6 and is well serviced by nearby restaurants, libraries, community halls, and is close to the National Concert Hall and theatres. The ethos of Cherryfield Lodge is based on that of the Jesuit Order. The principles observed in the care of the Residents and in dealing with staff are based on Jesuit core values. The mission and underlying values of Cherryfield Lodge are those of faith and justice, human dignity, compassion, quality and advocacy. The mission of Cherryfield Lodge is to provide a residential setting where residents are cared for while enabling them to lead a life which is as close as possible to that of other members of the Society of Jesus (Jesuit Order), and other religious orders in accordance with their present condition. Cherryfield Lodge is a twenty bed residential unit where residents (male only) can enjoy a good quality of life and are supported and valued within the care environment to promote their health and well-being. Male residents with the following care needs can be accommodated: general care, respite care, dementia care and those convalescing, providing 24 hour nursing care as provided and as directed by our policies and procedures. Jesuits, members of other religious orders and the general public may be admitted to Cherryfield Lodge and all levels of dependency are admitted.
Residents medical and nursing needs were met to a good standard and they were provided with timely access to general practitioner and allied health professional expertise to meet their needs. Staff practices observed and feedback from residents evidenced care that reflected residents' individual preferences and wishes with the exception of residents' activities needs which required improvement. Residents were safeguarded by effective procedures in the centre, stated they felt safe in the centre and their rights were respected.
Beneavin Lodge is supported by a Training Coordinator who works closely with the PIC and ADON. Training needs that have been identified are prioritized with an agreed timeframe for rollout. This occurs on a continuous basis and most recently included fire training and evacuation, safeguarding, infection control, MAPA, and food safety. There is ongoing MAPA training with seven staff recently completed and next training scheduled for 3/10/18. All new staff recruited attend a very comprehensive induction program to ensure they have the knowledge, skills and competency, to be rostered as part of our care team.
At the time of this inspection there was a suitable staff level and skill mix on each work shift to meet the assessed health and social care needs of residents accommodated. Residents spoken with confirmed staff will come when they use the call bell. Residents who preferred to spend time in their bedroom during the day and those who had retired to bed in the evening had the call bell placed by staff so it was within easy reach for residents. There were forward recruitment plans and contingency arrangements in place to manage a short fall in staff. An additional staff member has been rostered during the day since the beginning of October from 8.00hrs to 20.00hrs to support recently