Officer is due to meet with Cork County Council Fire Authority on site to discuss the planned works and to ascertain if any additional works may be required by the Fire Authority. These works will involve the widening of doors in a number of wards and will entail the reduction of beds in the hospital from 40 to 33, for which the Chief Officer has approved. The removal of these 7 beds has already taken place to allow for evacuation drills to happen and also to prepare for the
The policy on end of life care provided relevant guidance on meeting the needs of residents in relation to physical, emotional, social, psychological and spiritual care. The person in charge confirmed that training for staff was ongoing in how to meet the needs of residents and that all staff had attended training on ‘What matters to me’. Leaflets and information on bereavement and advanced care planning were available for staff and relatives. A number of staff had also undertaken training in advance care planning to inform discussion. The inspector reviewed the end-of-life care arrangements in place. Visitors and relatives spoken with by the inspector remarked on the good care and empathetic understanding demonstrated by staff and management. The person in charge confirmed that the centre maintained a single room for palliative care that was usually available for use by residents as required. Designated overnight facilities were not available for families within the centre but staff stated that family members who chose to remain overnight were made comfortable and provided with access to a facility for making refreshments. The centre was well supported by community resources in relation to spiritual care and memorial services took place at the chapel on site. Access to palliative care services was available when necessary in the centre.
1. Each staff nurse has been allocated the responsibility of an individual residents’ care plan. Refresher Training on Nursing Documentation is being given in September and October 2018 to all nursing staff to support this. Each residents’ care plan will be reviewed on a four monthly basis and also when a residents’ condition changes. The CNM2 now takes an active role in ensuring that all assessments, monthly weights, bloods etc are undertaken and that all new admissions care records are completed within 72 hours of admission.
committed to and arranged for an additional staff member to be on duty at night, increasing from four to five staff. At this inspection, the staff roster confirmed this arrangement was in place from 13th August until 30th September, however for three separate weeks of this period a fifth staff member was not in the centre at night. Staffing levels subsequently reverted back to four on duty at night when the numbers of residents living in the centre reduced without review of the totality of the risk associated with evacuating residents from the multi-bedded rooms which still remained.
basis. Residents' records confirmed that they were assisted to achieve and maintain the best possible health through regular blood profiling, monitoring of vital signs, quarterly medication review and annual administration of the influenza vaccine. Residents were referred as necessary to the acute hospital services and there was evidence of the exchange of comprehensive information on admission and discharge from hospital. A physiotherapist was present in the centre and a referral could be made by nurses or medical officer as required. The inspector also saw that residents had access to podiatry, dental, optical, dietetic and speech & language services as required. Residents in the centre also had access to the specialist mental health of later life services and to Psychology services. The psychiatrist and psychologist had offices based on the grounds of the centre and were available to review and follow up residents with mental health needs and residents who displayed behavioural symptoms of dementia.
The provider had developed a governance structure with lines of authority and accountability, however the inspectors found these to be ineffective. The provider completed a number of audits to review the quality and safety of care. From a review of the findings from this and previous inspections, inspectors were not satisfied that these audits were adequate to effectively monitor the services provided. A comprehensive review of the designated centre by the Director of Nursing, and a review of the service by the Nursing Practice Development Coordinator were planned for September 2018.
questionnaires were positive with regard to the control they had in their daily lives and the choices that they could make. Residents told inspectors about their daily routines, activity plans and interactions with the community. Residents expressed satisfaction regarding food and mealtimes and were happy with the support and assistance provided by staff. Residents were able to identify a staff member whom they would speak with if they were unhappy with something in the centre.
Inspectors viewed the staff training and education records. An overall training matrix was in place and individual records were maintained. Mandatory training was in place and training records confirmed that staff had received up to date training in fire safety, safe moving and handling, safeguarding vulnerable persons and training in responsive behaviours. However as identified and actioned in Outcomes 7 and 8 not all staff had training in safeguarding, responsive behaviours and fire training. Other training provided included, care planning, dementia specific training, infection control, end of life, syringe driver training, care planning, dysphagia and medication management. A lot of training was provided on site by external and internal trainers. Training facilities were available in house which including fully equipped conference and training rooms. The inspectors saw that other training courses had been booked and were scheduled for the coming months. Staff confirmed that they were facilitated and encouraged to attend training and through their staff appraisals were able to highlight their training needs.
The premises is a large hospital with a total bed capacity for 104 residents. Since the previous inspection the total number of beds had been reduced from 116, and a number of suitable external areas had been developed near each unit. The provider representative outlined how this reduction ensured that no more than four residents were residing in any of the multi-occupancy bedrooms. Furthermore, considerable efforts had been made by the provider representative to improve the interior décor and make each unit as homely as possible. Household furniture such as coffee tables, arm chairs, fire places and soft furnishings had been placed in sitting and communal rooms to create a more familiar and comfortable environment. This was particularly apparent in Ann's unit, where familiar items from the past such as vinyl records players and sewing machines were placed throughout the unit. Residents throughout the various units told inspectors that they were delighted with these improvements. For example, residents outlined how they now had more room for their furniture which allowed them to spend time more comfortably in their bedrooms, if they wished. Some residents showed inspectors their rooms
accommodated over two floors in single, double and quadruple rooms. The older and main part of the hospital comprised three floors. The ground floor was split into two levels with the upper level accessible via a platform type lift or by a stairs consisting of six steps. Bedroom accommodation on the ground floor comprised four single bedrooms and two twin bedrooms. Bedroom accommodation on the upper level of the ground floor comprised 1 single en-suite bedroom and one four-bedded en-suite room. Bedroom accommodation on the first floor comprised three single bedrooms, four twin bedrooms and two four-bedded rooms. The second floor was used primarily as office space but also contained the hairdressing salon. The first and second floors were accessible by a large elevator and by stairs. This older section was connected by a corridor and stairs to a more recently built section on a lower level. This newer 12-bedded section, was very nicely decorated and there was a lovely interactive atmosphere amongst residents and staff.
The CommunityHospital of the Assumption is a modern facility located on the outskirts of Thurles town. The centre is operated by the Health Service Executive (HSE) and is registered to accommodate a maximum of 60 residents. The service provides continuing care for people over 18 years of age across a range of abilities from low to maximum needs. The service also has facilities to provide respite, palliative and rehabilitative care. Care planning processes are in accordance with assessments using an appropriate range of validated assessment tools and
Records are kept on residents regarding special diets or fluid requirements as advised by Dietican or Speech and Language Therapist following referral. A copy of these recommendations are kept in the patients notes by the bedside , plus a copy give to the catering staff ,in addition to an individualised care plan being drawn up . Request for three day food diary are sought by the Dietican at times. The information on these diaries will be reviewed by The DON/CNM2 prior to submission to the Dietican and a note will be included to advise staff if more detailed information required. Plan to review food records by end June 2018 to ensure compliance.
The following information has been submitted by the provider representative and describes the service they provide. The registered provider of the centre is the Health Service Executive (HSE). This centre is a single storey premises that was originally opened in 1975. The premises is located on a large health campus on the Athy road in Carlow town. The centre was temporarily closed in August 2016 for renovations and premises improvements. These included improved palliative care facilities with an upgrade of four palliative care rooms each with ensuite facilities. Additional premises improvements were made to include the oratory, family
Residents stated that they enjoyed living in the centre. They had access to a variety of meaningful and entertaining activities. They said that visitors were unrestricted. They were familiar and comfortable with the person in charge and staff. Residents expressed satisfaction with all aspects of care. The views from the centre were spectacular and provided an opportunity for reminiscence, for example, one resident spoke with the inspector about her experience of living on the nearby island as a young person. Residents said that they felt safe, they were treated well and were encouraged to voice their opinion on any suggested improvements or proposed changes. Residents said that they were aware of the advocacy service which was advertised in the centre. They were consulted on a daily basis, during the annual survey and also at the two-monthly residents' meetings. A number of residents said that they went out with family members at weekends and that staff went with them to attend outpatient appointments. Resident praised staff members who guided them in chair-based exercise sessions and concerts. Community events were organised and transport was made available to residents to enable them to attend external events. Residents particularly liked the involvement of the West Cork Arts group. This group supported residents to create poetry, paintings and facilitated reminiscence sessions. Residents expressed their delight in the fact that their work was framed and displayed throughout the centre. They told the inspector that it was a great source of pride that their grandchildren were able to gain a better
Bandon CommunityHospital, established in 1929, is a single-storey building which had been extensively renovated. The designated centre is a Health Service Executive (HSE) establishment. It now consists of accommodation for 25 older adults set out in 21 single en-suite bedrooms and two double en-suite bedrooms. The centre provides long-term, respite and palliative care for local residents. There is an effective
The centre is located a short walk from the town of Carndonagh. On the site is a primary care centre and a day hospital. It is a single storey building and all areas were visibly clean. Equipment and appliances such as hoists, wheelchairs and walking aids were available to support and promote the independence of residents. The inspector reviewed all premises areas as residents with dementia could be accommodated throughout the unit, and in the dementia unit. The design and layout of the dementia unit was satisfactory with smaller dining and day spaces throughout the unit for up to 16 residents. On Oak and Elm some toilets and shower rooms had minor damage to floors and missing tiling which required maintenance and attention. The inspector was