This outcome sets out the findings relating to healthcare, nursing assessments and care planning. The findings in relation to the social care of residents with dementia will be discussed in Outcome 3. On the day of inspection approximately 70% of the residents in the center had a diagnosis of dementia or a similar condition. Care plans for a number of these residents were reviewed, focusing on the management of the symptoms of dementia, their nutritional needs, end of life plans, the management of falls and any specialist input the resident may have required following a change in their condition. Residents had a range of general practitioners (GPs) available to them within the centre. They could retain access to their own GP if they wished. There was good access
During the lunch time period staff were observed to offer assistance in a respectful and dignified manner. All staff sat beside the resident to whom they were giving assistance and were noted to patiently and gently encourage the resident throughout their meal. Independence was promoted and residents were encouraged to eat their meal at their own pace with minimal assistance to improve and maintain their functional capacity. The inspectors observed that some residents spent time in their rooms, and enjoyed reading, watching TV, or taking a nap. There was a private quiet room where residents could meet visitors in private.
activity. In the twin bedrooms staff used the bed screens when appropriate. There were no restrictions on visiting times; there were facilities to allow residents to receive visitors in private with rooms separate to residents' bedrooms were visitors and residents could meet. Numerous visitors were observed throughout both days of inspection where staff members knew the names of visitors and vice versa. Staff took time to talk with family members both when they visited and when they rang to enquire about their relative. It was evident that the management and staff of the centre were committed to residents leading the decisions relating to their care, and care and support was delivered in a manner that was dignified and respectful. Residents were also consulted about how the centre was planned and run through residents committee meetings, surveys and
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.
The design of the premises enabled residents to spend time in private and communal areas. Access to the well maintained garden was via a key code lock. Staff explained that some residents could remember the code but others would require staff assistance to go outside. The system could also be operated to override the key code. There was suitable seating provided in the patio and inspectors noted that none of the residents were sitting outside, although the day was warm and sunny.
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.
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
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.
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.
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.
Staff availed of a comprehensive programme of training including dementia care, moving and handling practices and the prevention, detection and response to abuse. There was an induction process in place for newly recruited staff. The inspectors were not satisfied that these staff members were appropriately supervised while completing the induction process, particularly while providing care to residents. On the day of the inspection, there was an inadequate number of staff trained in basic life support to perform cardiopulmonary resuscitation (CPR) in the event of an emergency. Training in CPR was scheduled for 22 March 2018.
On the previous inspections, inspectors were concerned about the number of nurses working in the centre that had full time posts elsewhere and the implications for the sustainability of the staffing arrangements. Since the last inspection one nurse had been newly recruited but the remaining nursing staff were part-time. The provider and person in charge also told the inspectors they had two new nurses recruited who were due to join the service in the next number of months on a full time basis which would eliminate the need for the reliance on part time staff.
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
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 inspector was satisfied that residents' weight changes were closely monitored. All residents were nutritionally assessed using a validated assessment tool. All residents were weighed regularly. Nursing staff told the inspector that if there was a change in a resident’s weight, nursing staff would reassess the resident, inform the GP and referrals would be made to the dietician and speech and language therapy (SALT). Files reviewed by the inspector confirmed this to be the case. Care plans in place were found to be person centered and very comprehensive. Nutritional supplements were administered as prescribed. All staff were aware of residents who required specialised diets or modified diets and were knowledgeable regarding the recommendations of the dietician and SALT.
Clearbrook NursingHome is a newly registered designated centre located in a north Dublin city suburb. The premises is two storey, purpose-built with 90 single en-suite bedrooms. The centre consists of four separate areas with central communal spaces including dining and sitting rooms. Full-time long and short-term care is provided for older people, people living with dementia, and people with physical and sensory disabilities.
Residents with health and social care needs at all dependency levels are considered for admission. Care is provided to residents who are independent and to those who require nursing care. Residents are accommodated on two floors. There are 39 single, six twin and four triple bedrooms, some with their own en-suite bathroom facility. Residents have access to safe enclosed courtyard gardens.