KilcaraHouseNursingHome is a family run designated centre set in a rural location within a few kilometres of the towns of Abbeyfeale and Listowel. It is registered to accommodate a maximum of 35 residents. It is a two-storey building with stairs and lift access to the upstairs accommodation. Downstairs it is set out in three wings: Abbeyfeale with eight beds, Duagh with nine beds, the new wing with eight beds; and upstairs has ten beds. Bedroom accommodation comprises single, twin and three-bedded rooms with wash-hand basins, and some have en suite shower and toilet facilities. Communal areas comprise two sitting rooms, a day room and dining room. There is a secure enclosed courtyard with seating and there is a mature garden with walkways and seating at the front entrance to the centre. KilcaraHousenursinghome provides 24-hour nursing care to both male and female residents whose dependency range from low to maximum care needs. Long-term,
Bethany House is a purpose built family run nursinghome located in the heart of Tyrrellspass, Co Westmeath. The centre can accommodate and is registered to care for a maximum of 57 residents, both male and female aged over 18 years. They provide 24 hour nursing care for residents of all dependency levels requiring general care, convalescence care, respite care and those requiring age related dementia care. They also care for young chronic sick residents including those with an acquired brain injury. The centre provides a comfortable, varied and spacious environment for 57 residents. A new extension was added to the premises in 2017, all
Beechlawn HouseNursingHome can accommodate up to 57 residents and provides care in the ethos of the Sisters of our Lady of Charity. The centre is primarily for religious sisters and females over 65 years old, however women under 65 can be accommodated also. The home comprises of 41 single ensuite bedrooms and 8 twin rooms and is divided into 3 wings. Each wing has its own lounge room, dining area and activity space. Medical and nursing care is provided on a 24-hour basis for residents with low to maximum dependency needs. There is an oratory and a large, secure garden area in addition to internal courtyards available for residents use. Physiotherapy, chiropody, optician and dental services are available and can be arranged for residents.
As part of the inspection, the inspector spent a period of time observing staff interactions with residents with a dementia. The observations took place in the day rooms and the dining room. Observations of the quality of interactions between residents and staff for selected periods of time indicated that 33% of interactions demonstrated positive connective care, 33% reflected task orientated care, 29% indicated neutral care while 5% of interactions classed as institutional or controlling care. These results were discussed with the management who attended the feedback meeting.
provider had submitted a completed self-assessment questionnaire on dementia care in their centre along with schedule 5 policies requested. The provider had assessed the centre as compliant in the outcomes examined within the self-assessment. The inspector focused on the experience of residents with dementia and met with management, staff, residents and relatives to assist in the inspection process. Practices and interactions between staff and residents were observed and discussed with staff and residents. The journey of a number of residents with dementia and their access to health and social care was tracked. Documentation such as clinical assessments, care plans, medical and allied health care reports, medication, complaints and property was reviewed. Staff rostering, training, meetings and recruitment records were also reviewed.
The inspector noted that a number of residents had been identified as having behaviours that challenge. Staff spoken with were clear on the support needs for residents exhibiting behaviours that challenge and the use of suitable de-escalating techniques. There was evidence that residents who presented with behaviours that challenge were reviewed by their GP and referred to other professionals for review and follow up, as required. However, as already identified under Regulation 5 in this report, care plans reviewed for residents who exhibited behaviours that challenge, required improvement. For example, the behavioural support records viewed were inadequate to mitigate future occurrences. While behaviours were recorded, the possible antecedents to the behaviour were not adequately identified and the
The fire policies and procedures viewed by inspectors were centre-specific. The fire safety plan was viewed by inspectors and found to be comprehensive. There were notices for residents and staff on “what to do in the case of a fire” appropriately placed throughout the building. Fire maps indicating escape routes were clearly displayed. Fire equipment training and fire evacuation training was provided. Staff demonstrated an appropriate knowledge and understanding of what to do in the event of a fire. The inspector examined the fire safety register with details of all services carried out which showed that fire fighting, fire safety equipment and fire alarms had been serviced as required and this was next due in May 2015. Fire alarm checks and automatic fire door release checks were carried out weekly and there was a daily fire door checking system. However, inspectors noted that one fire door in the laundry room was held open with containers of cleaning equipment. There was an emergency plan for the centre and inspectors were informed that the nearby home of the provider and the local resource centre could be used to provide accommodation for residents, in the event that an evacuation was necessary. Inspectors saw that this was formalised and outlined in the emergency plan.
This unannounced inspection found that a good standard of safe care was delivered to residents in a respectful and personalised manner. Residents had access to broad team of medical, nursing and specialist rehabilitative services, with regular and timely referral to these services found when required. Residents social needs were met through the provision of opportunities for meaningful engagement. A varied weekly activity programme was in place and there were more regular opportunities for residents to engage in community social events and outings. Progress was found on actions arising from the last inspection to devote more time to residents who, due to frailty, incapacity or choice usually did not take part in the group activities. The safety of residents was protected in the centre and advocacy services were available to residents to enable them to raise any issues of concern. Residents spoken with said they felt safe in the centre.
There was an effective governance structure in place that was accountable for the delivery of the service. The governance structures in place ensured clear lines of accountability so that all members of staff were aware of their responsibilities and who they were accountable to. The management team included two of the directors of Athlunkard NursingHome Ltd. The person in charge was the person nominated to represent the provider and she worked full time in the centre. The chairperson of the board of directors was the operations manager in the centre and visited on a weekly basis. Both directors were involved in the day to day running of the centre. The person in charge was further supported in her role by the assistant director of nursing (ADON), two clinical nurse managers (CNM's) and the administrator. The person in charge knew the residents well and was knowledgeable regarding their individual needs. The person in charge was available to meet with residents, family members and staff which allowed her to deal with any issues as they arose.
Following the inspection the registered provider, the person in charge and assistant director of nursing met with the pharmacist to discuss the medication management system and how to improve it. The Director of Nursing will continuously review the medicines management policies and procedures in place in the service to ensure that they are in line with evidence based practice and legislation, and that they continue to meet resident’s needs and expectations. The Director of Nursing and pharmacist will audit and review adherence by staff to the medicines management policies and procedures. The director of nursing will take appropriate action when these documented policies and procedures are not being adhered to. This ensures that medicines management is continuously improved in the service.
appropriate care and services in line with the statement of purpose. The provider had recruited a number of nursing and care staff to meet the increase in bed numbers. These staff had been in post since January 2018 and had completed induction training. Nursing staff were mentored by the assistant director of nursing. The centre had comprehensive quality management processes in place to monitor the safety and quality of care and services. Where improvements were identified these were communicated to the relevant staff and an appropriate action plan implemented.
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 a small number of residents who were assessed as requiring the use of bed rails in the centre. There was a clear policy on the use restrictive practices. The policy, practice and assessment forms reviewed reflected practice that was in line with national policy, as outlined in 'Towards a Restraint Free Environment in Nursing Homes' (2011). Alternatives to the use of any bedrails were documented in the resident's records. The provider was no involved in administering pensions or acting as a pension agent. A small number of residents had supports in place with storage of some items of personal property. The governance and oversight on this was found to be satisfactory and
Good systems of information governance were in place and the records required by the regulations were generally maintained effectively. Copies of the standards and regulations were readily available and accessible by staff. Maintenance records were in place for equipment such as hoists and . Records and documentation as required by Schedule 2, 3 and 4 of the regulations were securely controlled, maintained in good order and easily retrievable for monitoring purposes. Resident records such as care plans, assessments, medical notes and nursing records were complete. Other records such as a complaints log, records of notifications, fire checks and a directory of visitors were also available and effectively maintained. The centre had
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 provider/person in charge worked fulltime. The inspector observed that residents and relatives were familiar with the provider/person in charge and conversed freely with her. The deputy person in charge was full time employed; she worked part-time as assistant director of nursing and part-time on nursing duties. There was a fulltime clinical nurse manager in post to support the management team. The assistant operations manager supported the risk management team and provided in-house training for topics such as infection prevention and control, hand hygiene, and manual handling and lifting. They were all involved in the audit programme as part of risk management.
Elmgrove NursingHome provides accommodation for a maximum of 24 male and female residents, over 18 years of age. Residents are admitted on a long-term residential, respite and convalescence care basis. The centre is located on a mature site, at the end of a short avenue and within walking distance from Birr town centre. The premises is a listed period building. Residents' accommodation consists of 24 single bedrooms, located over three split floor levels. Shared toilets and washing facilities are available on each floor. The upper floors are accessible by stairs and stair lifts. A variety of communal rooms are provided for residents' use, including sitting, dining and recreational facilities. Each resident's dependency needs are regularly assessed to ensure their care needs are met. The provider employs a staff team consisting of registered nurses, care assistants, maintenance, activity,