now bedded down and staff are familiar and knowledgeable on the management of documentation. Policies and procedures around record management had been reviewed and communicated to all staff. The care planning system is clearly outlined and easily navigated. Residents had a comprehensive nursing assessment on admission. The assessment process involved the use of validated tools to assess each resident’s dependency level, risk of malnutrition, falls and their skin integrity. In addition, an assessment using a validated tool of the level of cognitive impairment of residents admitted with a diagnosis of dementia was recorded and subject to regular review. Clinical observations such as blood pressure, pulse and weight were assessed on admission and as required thereafter. The resuscitation status of all residents was
This centre was opened in 1984 and has undergone a series of major extension and improvement works since then. The premises consist of two floors with passenger lifts provided. It is located in a rural setting in north county Wexford close to Courtown. The centre is near to a range of local amenities including Courtown community and leisure centre, with a large swimming pool and a gym offering keep- fit and aerobics for the over-65s. Resident accommodation consists of 28 single bedrooms with en-suite facilities, four single bedrooms (without en-suites), nine twin bedrooms with en-suite facilities, a sitting room, an oratory, three lounges, a
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.
Audits are completed on a monthly basis and both the PIC and ADON have completed a quarterly analysis of all audits, which are highlighting decreasing levels of falls, and wound progression. Feedback is provided to staff on daily morning and night reports, and staff meetings. The analysis and feedback is provided to Group Senior Management, with further structures being developed to share learnings across the group. Any issues identified such as moving and handling practice, are supervised by CNM’s during clinical supervision. The Emergency policy has been reviewed, is currently being updated and will be made available to all by 28/09/18. Manual Handling training has been and will continue to be provided, with two sessions completed in the last two weeks.
The single storey building was built as a nursinghome in 2003. It was located near Milltown village in a scenic, country area. There were extensive gardens surrounding the building and residents had access to these for walks with family and staff. Adequate car parking spaces were provided. The person in charge stated that renovations were undertaken on an annual basis and the décor of the centre was consistently upgraded by the full-time maintenance person. Sitting, dining, dayroom and recreation rooms were spacious and provided adequate opportunity to allow private family visits, social events and communal activity sessions.
Records showed that where a resident was transferred to hospital or discharged from the centre the nursing staff provided relevant nursing and medical information to ensure a safe transfer of care or discharge back into the community setting. The inspector reviewed a concern relayed to the office of the Chief Inspector that described poor identification of a stroke. The information available indicated that staff had requested medical advice promptly and had acted on that advice. The resident had been admitted to hospital for a period and had returned to the centre and was almost back at normal activity levels.
The inspector viewed records of the staff meetings which had taken place this year. A range of issues were noted to have been discussed and included clinical care matters including the management of pressure wounds and weight changes and arrangements for the celebration of events significant to residents. The inspector found that staff had developed a good team spirit and several staff said that they worked collectively for the benefit of residents. For example, care and nursing staff supported and contributed to the activity programme by undertaking some activities and by supporting the activity coordinator during some of the scheduled activities.
Outline how you are going to come into compliance with Regulation 28: Fire precautions: As stated in the report the door closures that were not functioning properly on the day of inspection were repaired immediately by our in house maintenance team. Despite checks being carried out regularly by our staff doors will become damaged and we will ensure that any issues are entered in the maintenance book as soon as they are noticed so that the maintenance team can attend to them as soon as possible.
Outline how you are going to come into compliance with Regulation 28: Fire precautions: Revision of layout of Dining Room was carried out immediately and Fire Exit is no longer obstructed. All staff have been notified of changes through our Communication Book and same will be monitored on an ongoing basis.
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
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.
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.
Deputising arrangements were in place whereby the senior nurse was responsible for the service when necessary. Staff had up-to-date training and further training was scheduled for September and October 2018 following from the dementia thematic inspection in June 2018. There was one cleaning staff rostered six days a week from 08:30 - 14:30hrs Monday to Saturday, however, this was not always assured.
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.
Up-to-date registration numbers were in place for nursing staff. An actual and planned roster was maintained in the centre with any changes clearly indicated. The inspectors reviewed the roster which reflected the staff on duty and noted that there were at least two nurses on duty in a 24 hour period. An audit of staffing based on the dependencies of residents had recently been carried out and actions were being progressed to recruit two senior carers to supervise and support care staff in the delivery of care to residents. There were no volunteers in the centre at the time of inspection. The provider was aware of the requirements of the regulations in this regard.
Residents medical and nursing needs were met to a good standard and they were provided with timely access to general practitioner and allied health professional expertise to meet their needs. Staff practices observed and feedback from residents evidenced care that reflected residents' individual preferences and wishes with the exception of residents' activities needs which required improvement. Residents were safeguarded by effective procedures in the centre, stated they felt safe in the centre and their rights were respected.
are day rooms on each floor, a dining room on the ground floor and a lounge area on the middle floor. There is a new extension comprising seven single bedrooms with en-suite shower and toilet facilities and a visitors' room with comfortable seating and kitchenette facilities. Residents have access to gardens and walkways around the centre. Sonas NursingHome Melview provides 24-hour nursing care to both male and female residents. It can accommodate older people (over 65), those with a physical disability, mental health diagnoses and people who are under 65 whose care needs can be met by Sonas NursingHome Melview. Long-term care, convalescent care, respite and palliative care is provided to those who meet the criteria for admission. Maximum, high, medium and low dependency residents can be accommodated in the home.
Residents spoken with stated that they were happy in the centre. They praised the staff, the food and the activity programme. They said that they were happy to be accommodated in a centre where their privacy and dignity was assured through the provision of single and a small number of double rooms. They were seen to be familiar with staff and knew how to raise concerns. They felt that concerns would be addressed and said that they felt safe in the centre. A number of residents spoken with attended the residents' meetings and they said that they had spoken with the advocate who had helped with various issues. Mass was said weekly in the oratory. The conservatory and library rooms were very popular when visitors were present. Residents told the inspector that staff made great efforts to get to know their personal histories and the majority of residents were local to the area. They particularly like the music sessions two of which were arranged on the days of inspection. They were seen walking independently around the home using various walking aids and with the help of staff. Daily newspapers and fresh flowers were displayed on the hall table. A number of residents liked to sit in the large entrance foyer interacting with staff and visitors. The thi-chi exercise class was very popular even though the activity had to be modified now to meet the changing needs of residents. Residents were seen to enjoy this session on the second morning of the inspection. Residents spoke about the poetry readings and reminiscence sessions which they participated in with enthusiasm. A number of completed questionnaires received prior to the inspection contained positive comments which were reflective of the residents' views on the day of inspection.