The inspectors saw that on the units a large number of the residents spent long periods of the day in their bedrooms, either in bed or on a chair at their bedside. As residents sat by their own bedside and not close enough to engage in conversation with the resident in the bed next to them this meant that some residents had few opportunities to meet, interact and engage with each other on a social basis. In Fuschia unit many residents did attend the dining rooms for meals and activities. Some returned to their bedrooms immediately following same and others were seen to sit in a cosy sitting room. However, on this unit there were five bedded rooms where a number of residents were seen to spend their day. Staff told the inspector that residents from other
medications. Medications on Fuschia ward were dispensed by the pharmacist, labelled for each individual resident, and stored in resident named trays on the medication trolleys. Medications on Heather and Hawthornwards were not dispensed and labelled for individual residents but supplied as stock by the pharmacist and administered by nurses from the medication trolley; staff informed the inspectors that the new system would be implemented on these two wards in due course. The nurses on Fuschia ward reported that they found the new system safer and that it would the risk of medication error. On review of the system the inspector found that the new system for the supply of PRN (as required) medications had not yet been finalised. There were insufficient stocks on the trolley to meet the needs of the residents should they require a PRN (as required) medication. The inspector acknowledges that this system is in development, however the impact of this could result in a PRN (as required) medication not being available when needed for a resident.
On the previous inspection the inspectors visited every unit in the centre at 18.00 hours on the first evening of the inspection and found that the majority of residents in the centre were either in bed or sat beside their bed with the exception of one unit where approximately six of the residents were sitting in the day room watching TV. On this inspection although there were a number of residents in their beds or by their beds the majority of the residents were in the day rooms engaging in activities or up watching TV at this time. However staff said most of the residents would soon be returning to bed prior to the arrival of the night staff and reduction in staffing levels. To address some of these issues a twilight activity staff was due to commence employment to work between Heather and Hawthorn unit but this staff member had not commenced at the time of the inspection.
The unit which was inspected was St Joseph's Unit: a 24 bedded, single-storey centre, generally laid out in 'ward-style'' rooms. It had a bright, airy communal lounge, which was used for sitting and dining purposes. This room opened out through patio doors on to a secure patio area. The building was bright and very nicely painted and decorated. There were two staff offices, a storage room, a family room, a small kitchenette, a staff room and a number of utility and administration rooms in the centre. There were four multi-occupancy bedrooms in the centre which contained five beds each and four single rooms all of which had en-suite toilet and hand-washing facilities. Two assisted shower rooms were located at the top of the hall. There were two additional assisted toilets available for residents: one located in the hallway and one near the communal sitting area. The external grounds were extensive and provided sufficient car parking. The garden areas had been renovated through local fund-raising efforts and safe garden areas had been developed for residents' use. There was an outdoor smoking shelter available for residents. Residents with dementia were seen to access the safe outdoor space during the inspection.
Conservation objectives concentrate on the high conservation value sub-types of the habitat. Selection of the SAC for 3260 used a broad interpretation and the habitat's distribution and sub- types in the numerous rivers and streams have not been documented. Records for rare/threatened lotic plant and invertebrate species in the SAC indicate high conservation value. Note: rooted macrophytes should be trace/absent (<5% cover) in freshwater pearl mussel (Margaritifera margaritifera) habitat. The SAC overlaps with four freshwater pearl mussel SAC catchments: Caragh, Kerry Blackwater, Currane and Gearhameen (the first three are priority catchments). The freshwater pearl mussel (1029) conservation objective for this SAC and that for SAC 002173 take precedence because the mussel requires environmental conditions close to natural background levels
incidental occupation were available and seen to be used. There was story- telling and reminiscence therapy and the centre also had a sensory activation room. In keeping with the community culture there was an emphasis on musical events and sing-songs. The inspector met with a musician who regularly attended the centre and residents were seen to enjoy and participate in this activity. As a Gaeltacht area the community culture was evident in the language of choice between staff and residents. The inspector felt there was a good atmosphere in the centre and that residents were relaxed and at their ease. Residents who might express confusion or disorientation were readily reassured by staff. The inspector noted that residents had access to secure outside space for exercise and recreation. One resident was seen to go out repeatedly to walk about; this resident was appropriately attired with outdoor wear to ensure comfort and wellbeing while undertaking the activity. The centre also provided a well equipped hair-dressing facility for a hairdresser who came to the centre. The inspector spoke with a number of
Residents' religious needs were facilitated as there was a prayer area within the centre and residents also had access to pastoral care services. Residents' records confirmed that relatives as well as residents' friends were welcomed at various times of the day and there were areas for residents to meet their visitors. Residents’ relatives were encouraged and facilitated to be closely involved when their relative was receiving end of life care. There was a dedicated relatives' room which included recliner chairs, a television and facilities for making hot drinks and heating food and there was also an attached shower and toilet. Residents’ records indicated good communication between the health professionals supporting a resident at end of end of life and their respective relatives. The inspector found clear documented evidence that deceased residents’ personal belongings were returned to their identified representative/s.
This report set out the findings of a follow inspection of St Joseph’s Unit, in Listowel Community Hospital by the Health Information and Quality Authority (HIQA or the Authority). The hospital was a single storey premises, consisting of two units, St Joseph’s and the District. St Joseph's Unit was the designated section of the premises which was due for re registration. It was situated approximately one kilometre from the centre of Listowel town with car parking facilities at the front of the building. Long term residential, respite and palliative care was provided in St Joseph’s unit for 24 residents. Care was provided primarily for older adults. The centre also provided care for two younger residents with disabilities.
There were written policies and procedures in place for end-of-life care. Staff provided end of life care to residents with the support of their GP and the community palliative care team. Records indicated that end-of-life preferences were discussed with residents and/or their relatives and these were documented in residents' records. The inspector reviewed the record of a resident that had been considered active end of life. There was evidence of referral and review by the palliative care team. Narrative nursing notes indicated that the resident's needs were being met to a good standard. The care plan in place, however, was not updated to reflect the resident's current end of life status and there was insufficient detail contained in the plan to guide care.
Previous inspection reports identified issues with the premises at St Joseph’s Home, where areas of the physical environment were not suitable for the purpose of achieving the aims and objectives as set out in the statement of purpose including, for example, eight three-bedded rooms, narrow corridors and small clinical facilities. The size and layout of the aforementioned bedrooms were inadequate to ensure the needs, independence, privacy and dignity of residents.
Any significant reduction in the number of colonies with fertile fronds or juvenile sporophytes reported through ongoing monitoring should also be taken into account when assessing the Population attribute. Over half of populations monitored (57%) had fertile fronds recorded, although not all colonies in a population were necessarily fertile, nor were all fronds in a colony fertile. Lack of fertility at populations does not mean a population is in poor conservation condition, however, should fertile fronds be lost without replacement by young or unfurling fronds, it may be indicative of an unseen pressure. Therefore, after two reporting cycles, if fertile fronds are not observed in previously fertile populations AND if there is no evidence of new frond production based on frond counts (mature fertile or mature sterile fronds) and/or observation of young and/or unfurling fronds, then the status would be considered unfavourable – inadequate (amber) for this attribute. If however, frond numbers remain stable or increase at the colony(s) within populations, regardless of evidence of fertility, then the status remains favourable (green). If any fertile colonies are lost, with no evidence of production of new fronds (sterile, young or unfurling), then the population attribute would be considered unfavourable – bad (red), i.e. the loss of all fronds and future production of fronds (sterile or fertile) considered unlikely.
Killarney nursing home is two storey premises comprising 56 beds, of which 52 are single bedrooms and two are twin-bedded. The centre had suffered some damage caused by the dislodged roof of an adjacent building during a storm resulting in the temporary evacuation of the residents, however, all repair work had been completed prior to this inspection and all residents had returned to the centre.
schedule and organise outings in the community to the local garden centre for example. The centre provided a good range of activities including those specifically designed to support residents with dementia or cognitive impairment. The weekly activity schedule included morning and afternoon arrangements for activities such as music, arts and crafts, Sonas and exercise time. Staff were seen to engage creatively with cognitively impaired residents sometimes using specialised equipment such as interactive toy animals to good effect. The centre had two pet cats that were clearly popular and provided a positive focus for a number of residents. Residents could access secure outside space including a garden balcony on the first floor laid out with tables, seating and equipped with a barbecue and a seating area downstairs adjacent to the donkey paddock and chicken run. On the days of inspection a range of activities were observed including group sessions of music and dancing and also individualised one-to-one sessions. There was a regular hairdressing service with a well equipped salon available and seen to be used by residents in the course of the inspection.