participated in fire drills, including evacuation from the first floor, and could describe the different evacuation methods that may be required. There was a clear system in place to determine who was in charge of making decisions if a fire should occur. It was observed by some staff that there had been a significant increase in the awareness of the fire risks and evacuation requirements for the building, particularly those relating to the first floor level since the last inspection. Staff also observed that the recent increase in night time staffing levels from four to five staff members has significantly improved their confidence and ability to carry out the required fire evacuation procedures. However, 8 out of 41 staff had not received fire safety training within the past 12 months. During the inspection, the inspector was presented with written confirmation that fire safety training had been arranged for all staff for 1 and 2 October 2018 which would bring all staff fire safety training up to date.
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
Residents attended the general practitioners' (GPs) surgeries in the community or GPs called to the centre on different occasions during the week. Residents had timely access to all medical services, including the nearby primary care centre, specialist consultations and allied health professionals in accordance with their needs. This proactive approach promoted health and wellness. Inspectors reviewed minutes of meetings and listened to staff and residents' comments which indicated that there was a need to augment the physiotherapy hours and to support residents with OT involvement, particularly for the provision of suitable seating and hand- splints to prevent the deterioration of contractions. Cost for these services was not covered by the fair deal agreement for residents and were usually only available by referral to the HSE which was prone to delay. Residents could avail of private appointments with the in-house physiotherapist which avoided this delay. Initially inspectors were informed that 30 hours of physiotherapy were available weekly, however inspectors found that there were actually 16 hours of physiotherapy supplied by the provider on a weekly basis.
The centre is a period house with three floors and a bungalow. The ground floor contains the main communal rooms (two sitting rooms one of which is a combined sitting and dining room), and household facilities including the kitchen, laundry and sluice room. The first floor has a small sitting/dining room and a nurse’s station (not fully enclosed). Bedroom accommodation located on all floors consists of a mixture of single, twin and multi-occupied rooms. In accordance with the conditions of
There was evidence that staff had access to education and training, appropriate to their role and responsibilities. Since the last inspection all staff had received training in responsive behaviours and dementia care. Management have introduced an eLearning education programme to develop staffs’ skills and knowledge and to support mandatory training provided in house. In discussions with the inspector staff demonstrated that they were knowledgeable and skilled for example in fire safety procedures, safeguarding and safe moving and handling of residents. Staff were monitored and supervised.
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.
The origins of Milford Care Centre date back to 1928 when the Little Company of Mary Sisters established a NursingHome on Plassey Road near Castletroy, Limerick. In 1923, Milford House was purchased from the Russell Family as the Irish Novitiate of the Order and it was registered as a NursingHome in 1928. We have, as our core value, a belief in the dignity of the person in all stages of their lives and willingness to care for the whole person in body, mind and spirit. As part of the ongoing commitment to care, a purpose built Hospice and NursingHome with an outdoor garden was developed in June 1999. This was followed in December 2000 by the introduction of Day Care Services inclusive of Specialist Palliative Day Care and Older Adult Services. Milford Care Centre works in partnership with the HSE on an ongoing basis, subscribing and participating in joint collaborative strategies relating to its areas of speciality.
Kilcara HouseNursingHome 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. Kilcara Housenursinghome provides 24-hour nursing care to both male and female residents whose dependency range from low to maximum care needs. Long-term,
A programme of refurbishment and decorating was on-going and planned to commence 5 May 2018. A maintenance schedule was maintained to ensure issues to be addressed were logged, reported and completed. On the day of the inspection the centre was a comfortable temperature, well lit and ventilated. There were handrails on both sides of corridors and grab rails in the showers and bathrooms. Flooring was seen to be non slip and free from trip hazards. There were aids and adaptations available in the centre to meet the needs of the existing residents and sufficient storage to put them away when not in use.
The centre is a purpose built three storey construction that opened in 2015 and is located in Wexford town. The centre is registered to accommodate 71 residents. Residential accommodation is provided across three floors and consists of the following: The ground floor has 10 single ensuite bedrooms and one twin ensuite bedroom. The first floor has 25 single ensuite bedrooms and three twin ensuite bedrooms. The second floor contains 24 single ensuite bedrooms and two twin ensuite bedrooms. There are two passenger lifts to each floor. Each of the three floors had a central core area which was fitted out with couches and armchairs and there is also a communal day room on the second floor. There is one dining room on the ground floor that is large enough to accommodate all residents. The dining room has dividers that can be pushed back so the room can be used for a number of functions at the same time, for example activities. The main kitchen area is adjacent to the dining room. There are two smaller galley style kitchens on both the first and second floors. A number of bedrooms on the first and second floors have balcony areas which residents can also access. There is also a community resource building on site known as Davitt House which is a focal point for social, educational and religious activities. The provider is a limited company called Wygram NursingHome Limited. The centre provides care and support for both female and male adults over the age of 18 years requiring long-term, respite or convalescent care with low, medium, high and maximum dependency levels. The range of needs include the general care of the older person, residents with dementia and or a cognitive impairment and residents with intellectual disabilities. The centres stated aim is to meet the needs of residents by providing them with the highest level of person centered care in an environment that is safe, friendly and homely. Pre-admission assessments are completed to assess a potential resident's needs and whenever possible residents will be involved in the decision to live in the centre. The centre currently employs approximately 87 staff and there is 24-hour care and support provided by registered nursing and healthcare assistant staff with the support of housekeeping, catering, administration, laundry and maintenance staff.
• Staffing has been reviewed and will continuously be monitored using the methodology described above and will ensure that the number and skill mix of staff is appropriate to the number, dependency levels and assessed care needs of the residents, including changes in resident’s dependency levels, new admissions and residents returning from hospital. This will ensure that safety and quality of care is provided for residents. • Two additional nurses had been recruited and their contracts are now signed and further nurses will be recruited as necessary to ensure that our nursing staff
Each resident had a pre-admission assessment prior to coming to live at the designated centre. This helped to ensure that staff would be able to meet the person's current needs for care and support. Following admission the assessment information was used to develop a care plan with the resident and their family. A sample of care plans was reviewed by the inspector and were found to provide clear guidance on the nursing and care interventions that were in place to meet the resident's current needs and promoted the resident's independence and self-care abilities. Care plans were reviewed every four months or more often if the resident's needs changed.
Nursing staff were clear of residents’ needs, and described the actions they would take if changes in needs were identified, and examples were discussed where referrals had been made to healthcare professionals to ensure appropriate assessments were carried out. Where residents required emergency medication there were clear guidelines and protocols in place. Where residents were identified as having responsive behaviours care plans detailed how the resident may respond in different circumstances, things that may cause them to become upset or
provider/person in charge agreed that residents would greatly benefit if the post of activities coordinator was full-time and this was assured for 7th August 2018. On-going professional training was encouraged and facilitated, for example, three members of staff were near completion of their leadership course; the activities person had applied to do two courses relating to dementia-specific activation. Dementia training was scheduled for 24th July2018; infection prevention and control including hand
and available in sufficient quantities. There was a tea party taking place on the first day of the inspection and residents appeared to very much enjoy the event. These are monthly occurrences and the chef prepares a variety of foods for the residents, including pastries, as a special treat for residents. Residents requiring assistance at meal times are assisted appropriately by staff and a special table is available for residents that have large speciality chairs. While there was an adequate system for nursing staff to communicate speciality diets with catering staff, it was noted by the inspector that for one resident the diet sheet in use did not reflect the prescribed diet.
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.
dependency to maximum dependency and provides long-term residential and nursing care, convalescent care and respite services. The new premises is purpose built over three levels. Accommodation consists of single and twin bedrooms, all of which have accessible en-suite facilities. Each floor has a communal lounge and dining room. There is a large reception area, activities room, a sensory (quiet) room,
Staff were observed to treat residents in a dignified manner and in a way that maximised their choice and independence. Residents had access to radio, television, the Internet and Skype. Some residents were supported to attend weekly day care centres in the local community. Residents varying religious and political rights were supported. Mass was celebrated in the centre every two weeks while some residents were supported to attend the local church. Residents were facilitated to vote in house.