St. Joseph's Home is a 40 bedded nursing home that was purpose built in the 1970s. It is accessed via a long driveway and situated approximately one kilometre from Killrorglin town. The centre is divided into two sections, St. Bridget's (rooms 1 to 12) and St. Patrick's (rooms 13 to 23). Bedroom accommodation comprises 14 single bedrooms, one twin bedroom and eight triple bedrooms. Communal space comprises a large sitting room, two small sitting rooms and a seating area in a recessed archway. There was also a kitchen with sufficient cooking facilities and a large dining room.
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.
attended up-to-date fire safety training. There were daily checks of means of escape to ensure that emergency exits remained unobstructed. All safety checks, however, were not conducted in accordance with fire safety guidance issued by HIQA. For example, the fire alarm was not sounded weekly to assess if it was functioning appropriately and that all fire doors would close when the fire alarm sounded. There was fire safety signage on display at intervals along the corridor identifying the evacuation process in St. Mary's wing, however, this had not yet been put in place in the new wing. The fire safety signage identified where you were in the centre in relation to the nearest emergency exit. It did not, however, clearly identify fire compartments within the centre so that staff could identify places of relative safety within the centre in the event of a requirement for horizontal evacuation. While staff members spoken with were knowledgeable of what to do in the event of a fire, they were not clear on which fire doors formed the perimeter of each fire compartment. Fire drills were conducted at frequent intervals. The record of fire drills required review, as it did not provide adequate detail of scenario simulated, the time it would take to evacuate all residents from a compartment and any learning from the drill.
Similar to findings on the previous inspection, inspectors found that there was adequate private and communal space in the centre. There were three sitting rooms downstairs, an oratory and an interlinked dining room/conservatory area. The smokers' room in the centre had been tidied up since the previous inspection and the door from this room was now closed when in use. The centre was clean and generally in good repair. Inspectors saw evidence of a cleaning schedule for all areas. The kitchen was located in the centre of the home and was easily accessible to staff and residents.
Documentation confirming attendance at activities, or non attendance, was maintained. However, this documentation was not adequate, as it did not clearly highlight which residents had attended the activities. The activity co-ordinator, who was spoken with, stated that she was assigned to activities daily from 11.00 until 15.00. She stated she would adjust the activity documentation, to ensure clarity. She was found to be enthusiastic about her role and knowledgeable about residents' likes and dislikes. Life stories were available for each resident. This documentation included details of residents' individual interests, level of communication, preferences and background. These had not been included in each resident's individual care plan, however staff were aware of where to access the information. Residents had care plans for the
outskirts of Abbeydorney, Kerry. There was access from the main road to a large car park at the side of the premises. Resident accommodation was laid out on the ground floor only. The centre provided accommodation for up to 27 residents comprising 3 single rooms, one of which was en-suite, and 12 twin rooms, all provided with wash- hand basins. All rooms were appropriately furnished, with adequate storage and equipment as necessary. All twin rooms had privacy screens in place. All rooms had a radio or television and were fitted with call-bell facilities. Bathroom and toilet facilities were accessible and appropriately located throughout the centre; these facilities were well equipped and maintained. There was a large garden area at the back of the
There were two care staff allocated to the function of activity co-ordinators on a part time basis that fulfilled a role in meeting the social needs of residents and the inspector observed that staff generally connected with residents as individuals. There was a programme of activities available to residents which included art, flower arranging, bingo, sing-songs, exercise sessions religious activities and other more individualised activities. Residents and relatives told the inspectors how much they enjoyed the activities. However a number of residents told the inspector and identified it on the questionnaires and in the residents committee that they would like some live music. The person in charge said they were sourcing same and had planned for a harpist to visit the centre. The inspector observed that residents were free to join in an activity or to spend quiet time in their room. However as identified on the concern received by HIQA there was a lack of activities and social stimulation for a number of residents who spent the day in bed. The inspector observed staff undertaking regular checks on these residents but other interactions were limited and residents spent long periods of the day with little social interaction. The inspector checked the care plans for these residents and a more comprehensive social stimulation and care plan was required. This is outlined under care planning in Outcome 11.
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.
Inspectors spoke with the chef who said that he regularly met with the person in charge to discuss residents' dietary needs. The chef showed inspectors his files which contained relevant information including a copy of the most recent assessments carried out by the speech and language therapist, the dietician and a record of residents’ food preferences. The chef indicated that he received relevant training in nutrition. For example, HACCP (Hazard Analysis Critical Control Points) training had been updated. The chef explained to inspectors how he ensured that the diet was nutritious by having a variety of meat, vegetables and fruit sourced from a reputable local suppliers, as well as providing home baked bread and cakes. He was familiar with the special dietary requirements and the needs of residents who required modified or fortified diets. The kitchen was seen to be very clean and modern. Snacks and drinks were readily available throughout the day. A sample of medication administration charts and care plans were reviewed by
The second action plan received by the Authority did not provide adequate reassurance that the Regulations regarding three day notifications were being complied with in the nursing home as per the requirements of paragraph 7 (i) to (j) of Schedule 4 of the Regulations. For example, a sudden death of a resident and an allegation of peer abuse had not been notified to the Authority within three days of their occurrence or were not submitted retrospectively, as requested on two occasions, by the Authority in the action plans set out for the provider.