HEALTH WATCHDOG HIQA has issued a report detailing concerns about elderly residents being restrained by staff at a nursing home in the north Dublin suburb of Raheny.
The Hiqa inspectors also found that residents were being rushed through their breakfast routine at the centre, and that there were problems with the level of staffing – particularly in the mornings.
The inspection of Raheny Community Nursing Unit, which is run by Beaumont Hospital, was carried out last October, the report published today said.
There were 96 residents at the Harmonstown Road centre on the day the inspection was carried out.
The report summary says that Hiqa carried out its unannounced visit on the back of unsolicited information provided to the body.
Overall, the centre was “clean and well maintained in the areas inspected” during the two-day visit.
“Residents’ rooms were personalised and those viewed were suitably equipped to meet their individual needs.
Residents and relatives spoken with said they did not have any concerns for their safety.
However, inspectors found that significant improvements were needed in relation to safeguarding practices and staff supervision:
Inspectors were not satisfied that adequate safeguarding arrangements were put in place, to safeguard residents, when there were suspicions or allegations of abuse.
Improvements were required, inspectors said, in relation to:
Restraint
Regarding the use of restraint, inspectors found “instances where limitations of residents’ freedom through physical holding during personal care interventions were used”.
According to the report:
“Inspectors were told that this restraint was used to manage responsive behaviours associated with personal care and had been discussed and agreed with the multi
-disciplinary team and the residents family. However, evidence of the discussion and agreements were not available.”
The review of staffing levels during mornings was recommended as “inspectors observed that staff were rushed and there were delays in meeting residents’ needs or preferences”.
Inspectors observed that the assistance provided to residents during the breakfast service to be particularly rushed. Regular staff were seen rushing to ensure all residents were seated upright to enable them have their breakfasts in a timely manner.
Staff spoken with at this time said they were trying to make sure everyone got their breakfast when it was hot. The staff said they were working with a lot of agency staff who did not know the residents well, and this created more pressure on the regular staff, who had to check all the residents in their allocated area.
However, there were negative impacts to this rushed care provision, including where residents were assisted to eat their breakfast, prior to their soiled incontinence wear being changed.
Criticism
Age Action, the advocacy organisation for older people, said that physically restraining an older person in a residential care facility should only ever be undertaken as an emergency measure.
“It is scandalous that it appears to have been occurring here without any proper monitoring or reporting,” Justin Moran, Age Action’s head of advocacy, said.
Moran also said the practices outlined during the residents’ morning routines “should not be happening anywhere but especially in a facility designed to provide care for older people”.
He concluded:
It’s important that Hiqa inspects this facility again soon to ensure that the actions required by this report are carried out.
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