ALLEGATIONS HAVE BEEN made regarding incidents of abuse, unexplained injuries and poor hygiene standards in nursing homes in Ireland, according to documents released to TheJournal.ie under the Freedom of Information Act.
The documents show that between June and October of this year specific concerns were raised about staff shortages, residents falling, nutrition, and fire and safety issues.
In one piece of correspondence sent to the health watchdog Hiqa, it is alleged that a person’s relative was attacked in a nursing home and “received severe injuries which required medical attention and hospitalisation”.
In the same entry, it is claimed that the relative was “sent to hospital unaccompanied” and that the family was “not notified on incidents of abuse.”
Another piece of information from a concerned person claims that a resident was “pushed by another resident in the corridor” of the nursing home and that the resident has been “quite upset since the incident”.
The documents concern unsolicited information received by Hiqa in relation to older persons’ services from 5 June to 21 October.
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 relating to the centres and people involved is removed, in order to respect their privacy.
Despite this, the concerns give a real glimpse into the issues in residential care centres and nursing homes across Ireland.
The issues raised with Hiqa sent through unsolicited information over the course of the period range from personal belongings going missing, lack of supervision, staffing issues, and concerns over food provision, to an overall lack of care.
On 28 November, Hiqa published 32 inspection reports on nursing homes in Ireland. Evidence of good practice and compliance with the regulations and standards were found in 18 centres.
However, evidence of non-compliance was found in 14 centres. In these centres, the providers failed to ensure that the service delivered to residents was effectively monitored in line with the regulations and standards.
Inspectors identified non-compliances in areas such as staffing, governance and management, infection prevention, fire precautions, residents’ rights and individual assessment and care plans.
It must be noted, that the details within the FOI documents may not relate to the above nursing homes, as the complaints do not specify which nursing home they are about.
Hygiene issues
In the FOI documents, multiple instances of issues with hygiene standards are detailed.
In one instance, a concerned person (CP) claimed that a shortage of staff was impacting the care of residents and that “soiled sheets” had not been changed.
Another person alleged that there were “poor hygiene standards in the rooms of dementia residents” in the nursing home in question.
They claimed that there were “faeces on [the] resident’s bedroom floor” and that there were “no paper towels in the bathrooms”.
Another person complained to Hiqa that there was a “strong odour of urine” in a resident’s bedroom.
One person claimed that a resident is “not assisted with personal hygiene on a daily basis” and that “proper toiletries are not used to clean residents after they soil themselves”.
They alleged:
Residents are left in soiled pads and are not changed for hours.
Other complaints
Other common issues raised within the documents include staffing issues, an overall lack of care, and concerns over fire safety issues.
Numerous concerns were raised throughout the documents of residents falling and sustaining injuries.
In one instance, it is alleged that a resident has sustained a number of falls in recent years and that the latest fall has “caused a serious bleed to the brain”.
Another person alleged that the family were not informed as to how a resident ended up falling.
One person claimed that there was “unexplained bruising” on a resident’s face. A number of complaints surround concerns over a general lack of care within the nursing homes in question.
For example, it is alleged in one case that residents are being left sitting in their wheelchairs all day, due to a “shortage of chairs for them to sit in”.
In another instance, it is alleged that “residents are verbally abused by care staff”.
On a similar theme, multiple complaints were made regarding staff shortages at nursing homes.
One person alleged that there was a “poor quality of care to residents who required assistance”.
They claimed:
Not enough staff on duty to meet the dependency needs of residents.
Another person claimed that there were “not enough staff supervising residents, especially in dementia area”.
The person also claimed there was a lack of staff in the nursing home “to help with toileting” and a lack of staff “helping with meal times”.
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.
Speaking to TheJournal.ie in August regarding previous documents of unsolicited information, Fine Gael TD Fergus O’Dowd noted Hiqa’s lack of remit to investigate individual complaints.
“I’d be very concerned that [the complaints] never trigger, as far as I understand, an immediate investigation of the individual.
[Hiqa] can go in [to a nursing home], but they can’t ask for the file of the individual which doesn’t make sense and you need a lot more accountability from Hiqa as to what they are actually doing.
As noted above, 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.
“I think that the [identity] of the individual should never be disclosed but I don’t see why there shouldn’t be as little redaction as possible because you need to know the full detail of what culpability or what are the responses of the actual institution to the complaints that are made,” O’Dowd said.
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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