A TOTAL OF 11 nursing homes in Ireland have closed by the Health Information and Quality Authority (HIQA) since 2010, with the latest being sut down this week.
HIQA, the body responsible for setting, implementing and monitoring standards of care in older persons’ residential care settings, carried out a total of 813 inspection visits of residential care centres in 2010. They carried out 769 inspection visits of residential centres in 2011.
Each of the centres which received notice to close was subjected to five inspections on average – with one centre receiving a total of ten inspections, according to an analysis of more than 1,500 HIQA inspections of nursing homes by specialist health consultants and trainers to Ireland’s health and social care sector, The Wolfe Group (formerly known as Joe Wolfe & Associates).
Although centres were given agreed action plans and considerable time to improve standards, an average of 17 months from first inspection, they did not adequately improve.
Of the centres that closed, the most frequent areas of non-compliance identified in HIQA’s inspection reports were the regulation on general welfare and protection (88 per cent); the regulation relating to medicine (82 per cent); the regulation on assessment and care planning (82 per cent); and the regulation on rights, dignity and consultation (76 per cent).
The nursing homes closed were:
Individual findings
At Owenriff Nursing Home in Oughterard, Co Galway, (the centre most recently announced closed) inspectors found that most residents had not had a bath or shower in the previous month.
The final inspection report into another closed centre also unearthed medication errors. One male resident had “received chemical restraint [a sedative] on 18 occasions over 11 days without an appropriate record being maintained,” according to the document. This was despite that fact that there have been no records of agitated or aggressive behaviour from the elderly resident.
In the same home, inspectors also found that one resident has sustained a serious injury – a fractured hip – following a fall. The resident’s plan of care had indicated that she should be supervised in the bathroom – however, she had been in the bathroom unsupervised when she fell and injured herself.
In a final report of yet another closed centre, inspectors found that the nursing home had “commenced a process of discharging all residents within a 24-hour to 48-hour period” – an arrangement which was unplanned, not communicated to residents, families or general practitioners and created “unnecessary trauma, upset, medical and mental health risks for the residents.”
A final report into another shut-down centre stated significant findings demonstrated “an absence of strong clinical leadership, clinical competency and a sound, contemporary evidence base to care and practice”. The inspector noted that suitable and sufficient care was not facilitated at all time for residents in line with their dependency and their assessed and changing needs.
Evidence of ongoing poor and inconsistent practice in care planning, wound prevention and management, the documentation of, investigation and appropriate action in relation to accidents and incidents, recruitment practices and induction and supervision of staff was also observed.
More closures ‘highly likely’
Joe Wolfe, founding partner of The Wolfe Group, commented on the findings: “We undertook this research to see how our experiences on the ground compared with official reports and to help other healthcare sectors prepare for upcoming HIQA inspection. Despite our analysis finding some shocking reports, in our view and from our analysis of regulators of health and social care internationally, HIQA is one of the best regulators worldwide and are rigorous in inspecting services.”
He added that inspections were ongoing and it was “highly likely” that there will be more closures before the end of this year.
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