resident’s circumstances changed. Nursing care plans were in place that outlined the individualised nursing care that a resident required based on their assessed needs. The inspector reviewed a sample of allied health records for residents whom had recently received end of life care in the centre. The records indicated that residents had received well coordinated multi-disciplinary care. That they had been frequently reviewed by their general medical practitioner, a pharmacist had been involved in reviewing the residents' medicines and specialised community palliative care services had been made available when required.
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
During a previous HIQA inspection in November 2015, it was identified that that the hospital did not have access to twenty-four hour a day clinical microbiology advice and that there was no consultant microbiologist oversight of laboratory results generated by the microbiology laboratory. Instead, an arrangement was in place for support from a consultant microbiologist who was substantively employed by a nearby private hospital, amounting to a commitment of four hours per week onsite and some telephone access from 9-5pm Monday to Friday. At that time, this risk was communicated to both hospital management and the HSE South/South West
As previously explained our focus moved from knowledge building to classifying the data, so that previously unseen data could be found within it. To start it was decided tha t the relevant attributes should be found in relation to the severity of the accident. As shown within the results section, the most relevant attribute was the accident time. This can be explained by the increased traffic flow during rush hour periods. More cars on the road increasing the chances of an accident occurring. This was also found within some of the research carried out on the subject area, and also that during weekends traffic levels are highest in the time between 10am and 12pm. Two attributes that we where surprised not to see in these results where weather and lighting, which are normally viewed as being large factors in many road traffic accidents. One reason for this might be because in adverse conditions drivers are more likely to con centrate harder therefore reducing the possibility of an accident.
The person in charge was involved in the centre on a daily basis and was found to be easily accessible to residents, relatives and staff. There was evidence of individual resident's needs being met and staff supported residents in maintaining their independence where possible. Community and family involvement was encouraged and visitors were seen to be plentiful throughout the day . There was an activities programme and an advocacy service available for residents.
Community Nursing Unit will expire 07/06/16.) During this inspection the provider nominee requested to change the purpose of the inspection from an application to vary conditions of registration to an application to renew registration and increase bed capacity from 19 to 41, and this was facilitated. This renewal of registration inspection took place over two days. As part of the inspection the inspector met with residents, relatives, Provider Nominee, Person in Charge, Clinical Nurse Manager (CNM 2), Clinical Development Co-ordinator for the KerryCommunity Hospitals and staff members. The inspector observed practices and reviewed governance, clinical and operational documentation to inform this registration renewal application. The provider nominee and person in charge displayed good knowledge of the standards and regulatory requirements.
Residents had access to newspapers, TV and radio. Photographs on display in residents’ bedrooms indicated the involvement of residents and their family members at events in the centre. Residents were encouraged to partake in newspaper reading, conversation, card games, art and crafts and puzzles in order to maintain cognitive ability and social interaction. Throughout the inspection there were a number of activities planned. The inspector was present for a music session, a quiz, and exercises to music. A number of staff and enthusiastic external entertainers facilitated these. According to the person in charge residents benefitted from community involvement. Each Thursday residents went to the large day room to meet with residents from the community centre. They played cards together and the group were entertained by local musicians. A group of 20 residents were seen to join with a group of ten people from the community for the music session on the first day of inspection. Mass was celebrated each Monday in the central hallway of the centre. One 92 year old resident stated ''Ashborough Lodge has become my home''. Another resident stated ''you are offered tea and sympathy, we are blessed''.
The premises is a purpose built two-storey building which accommodated an out-patient physiotherapy department, a mental health day service as well as Kenmare Community Nursing Unit. The premises were very clean, bright and well maintained, with adequate space to ensure privacy, dignity and autonomy of residents. There was lift and stairs access to the upstairs. Downstairs accommodation, Sheen House, comprised one twin bedroom with en suite facilities and 17 single en suite bedrooms. Within the unit communal space included a quiet sun room, day room and dining room; comfortable seating areas were located along the wide corridors. Within the main foyer of the premises there was a prayer room, family overnight accommodation and a family meeting room. Clinical rooms were secured to prevent unauthorised entry. Upstairs accommodation comprised two units; Caha House which was a secure self-contained six-bedded unit with a dining room and a day room and a large foyer with comfortable seating areas; the second unit was Roughty House with accommodation for 16 residents with 14 single en suite bedrooms and one twin en suite bedroom. Additional assisted toilets and bathrooms were available in each unit.
The centre was located within an island community and many of both staff and residents came from the local area. Throughout the course of the inspection visitors came and went at the centre and people were clearly familiar with regular visitors. The inspector spoke with some of the visitors who all remarked on the very good care and communication they experienced at the centre. As identified on previous inspections, arrangements for accommodation in two multi-occupancy rooms, for up to four people, did not support adequate privacy for residents in the conduct of their personal activities. For example, named photographs were on each bed in the four-bedded rooms. The person in charge explained that this practise supported residents with a cognitive impairment to orientate themselves within the space and help them identify their area and bed. However, the practice itself was in place to compensate for the circumstances of communal residential accommodation, and did not support the privacy and dignity of individual residents. Resident areas in these wards were personalised with photographs and belongings and adequate personal storage was accessible. Privacy screens were in use. However, they were inadequate in ensuring privacy of communication between residents and visitors. Additionally, there was no designated space for residents to receive visitors in private. As a consequence, the inspection assessed this outcome as moderately non-compliant where the self-assessment had been compliant.
Residents were usually admitted through the public health nursing service. A common summary assessment report (CSAR) was completed by a placement coordinator and other relevant healthcare professionals, detailing the health needs of each resident. A copy of this report was available in each resident's record. Pre-admission assessments were not routinely carried out on all residents prior to admission to the centre, however, many of the residents had spent some time in the centre on respite prior to becoming permanent residents and therefore staff were usually familiar with the residents. Residents had access to general practitioners (GPs) of their choice. Medical notes indicated that residents were reviewed regularly by their respective GPs. Out-of-hours GP services were also available and readily accessible, as they were based adjacent to the centre. Residents had good access to allied healthcare services due to the co- location of the centre with a day hospital and a mental health day centre. A
A physician from Kerry General Hospital attended the centre once a month; a surgeon attended once a month and residents have access to this service for minor surgery; the physiotherapist attended the centre daily for one hour and residents had access to the physiotherapy department on site; the dietician attended once a month; residents had access to a consultant-led palliative care service from Tralee; access to the speech and language therapist was available upon referral. Documentation indicated that, within the last two years, one resident died and had their end-of-life care needs addressed without the need for transfer to an acute hospital.