NURSING HOME CARE assistants were accused in a complaint to Hiqa of pinching residents around the waist area if they did not cooperate, according to documents released to TheJournal.ie under the Freedom of Information Act.
The documents from Hiqa (the Health Information and Quality Authority) outline an allegation of “mistreatment of the residents by a couple of care assistants”.
In that same entry – which is heavily redacted in places – the following account is given:
“If residents are not cooperating with the care assistants they pinch the residents around the waist area where any bruises will not be easily seen.
When residents complain when the shower is either too cold or too hot, the care assistants hit the residents over the head with the shower head.
“Care assistants put a pillow against a [REDACTED] resident and punched [REDACTED] and as a result [REDACTED] was upset and in pain.”
The account continues to allege that “a resident having afternoon tea in the communal room tried to speak out about the abusive treatment and was pinched around the waist and forcibly taken from the room”.
The documents concern unsolicited information received by Hiqa in relation to older persons’ services from 1 January to 20 June 2018.
The documents detail issues recorded by the agency’s staff. In some cases, the issues are summarised by an employee and refer to the person raising the issue as a CP (concerned person).
Hiqa is responsible for the monitoring, inspection and registration of designated centres for older people, such as nursing homes, in Ireland.
The information comes from anyone concerned about something in a nursing home.
The concerns are heavily redacted in places and are undated. All identifying material of the centres and people involved are removed, in order to respect their privacy.
Despite this, the concerns give a real glimpse into the widespread issues and failings in residential care centres and nursing homes across Ireland.
The issues raised with Hiqa sent through unsolicited information over the course of the period outlined above range from physical abuse of residents, elderly people being left without help after soiling themselves, inadequate staffing, concerns over food provision, and an overall lack of care.
In April, Hiqa published 23 reports on nursing homes in Ireland. Evidence of good practice and compliance with the regulations and standards was found in 17 centres. However, evidence of non-compliance was found in six centres.
Abuse
In one report contained in the FOI document, it is alleged that one resident told the concerned person that “they are being sexually assaulted by a staff member during night time hours, in their bedroom”.
“The staff member touches parts of the resident’s upper body, which is inappropriate. [REDACTED]. The resident pretends to be asleep, and does not know how or whom to confide in.
“As a result of the abuse, resident is emotionally and physically sick due to stress and has sworn they are truthful in their statement regarding the abuse,” the complainant alleges.
In another instance in the documents, a complainant said: “Staff reported a sexual assault on two [REDACTED] residents by a [REDACTED] resident.”
Meanwhile, another complainant claimed that “one resident was crying while a care assistant was being physically rough with the resident”.
Another complaint alleges: “[REDACTED] abused a resident and was dismissed. That person went on to work in another local health service and later to another centre. The person has returned to the nursing home and CP is anxious about safety and care and residents.”
In another case, it was claimed that a “member of staff physically and emotionally abused” a resident. “A pillow was placed on resident’s upper body and resident was threatened.”
Other complaints
Other common issues involve residents suffering falls, staffing issues and hygiene concerns.
One document alleges that “there is no assistance to ensure resident is comfortable in the bed and the resident is often found lying sideways and sliding down the bed”.
Another concerned person alleged that the entrance to a centre had “a bad odour of urine”.
Another concerned person claimed that “in the resident’s room, there are soiled nappies constantly lying around”.
In relation to hygiene concerns, one person alleged that a resident was “left in bed while soiled” and had “no assistance with personal hygiene”.
Another document claimed:
There was no assistance or encouragement with personal hygiene and resident was lying in a bed in a soiled, saturated nappy.
“The resident was emotionally upset and told CP there was pain with no relief. Although CP asked for assistance for the resident none was provided.”
In relation to the provision of meals in the centres, Hiqa received numerous unsolicited pieces of information.
One document claimed that a “resident has swallowing difficulties and requires food served a certain texture”.
CP observed a care assistant shove a large tablespoon into the resident’s mouth. The resident spat the food out as they were unable to swallow the large amount given. The care assistant continued to shove another large spoonful into the resident’s mouth, not giving them a chance to breath. A nurse who stood alongside CP also witnessed this incident and apologised to CP for the care assistant’s behaviour.
In relation to instances of falls, one concerned person claimed they discovered a resident on the bedroom floor and “no assistance was available”.
Another document mentioned that a resident is blind and requires walking assistance, and that they “suffered a fall and was assaulted by another resident”.
Hiqa’s role
Hiqa does not have a remit to investigate individual complaints. However, all unsolicited information, which can be received from anyone concerned about a centre, is used to inform the watchdog’s monitoring of each residential centre.
Hiqa monitors and inspects designated centres for older people, such as nursing homes, against regulation and standards.
Where there are risks to the safety of residents or where the provider has failed to address areas of concern repeatedly, Hiqa can take escalated action, up to and including court action to cancel the registration of a centre.
“The aim of the Health Information and Quality Authority is to advance high-quality and safe care for people accessing health and social care services in Ireland,” a spokesperson for Hiqa said.
“Where Hiqa has concerns related to the safety of residents and the quality of care that they are receiving, providers are required to take immediate action to address this.
Hiqa inspectors follow up with providers to ensure that the actions are being implemented and are resulting in improvements for residents.
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