Watchdog Hiqa has raised concerns about the treatment of elderly residents at two separate nursing homes in Waterford.
Waterford Nursing Home on the Dunmore Road, which is operated privately by Mowlam Healthcare and Dungarvan Community Hospital were inspected last November and September, respectively, with the results published last week.
Officials from the Health Information and Quality Authority (Hiqa) had received two separate concerns in relation to potential issues of safeguarding vulnerable adults at Waterford Nursing Home prior to their unannounced inspection. The first of these concerns related to an allegation of institutional practice whereby residents were being washed and dressed before day staff began duty at 8am. Amongst those being woken early, it was claimed, were residents who received night sedation. The second concern related to the removal of a call bell from a resident at night.
Hiqa inspectors found that, by 6:05am, there were two residents awake and dressed and sitting in the dayroom. A further two residents were dressed and in the dayroom by 6.30am, while cleaning staff were also washing and polishing floors at 6.30am with a machine that could be heard throughout the ground floor. Night staff said they had been asked to have residents up and dressed to help the day staff, who started at 8am.
However Mowlam Healthcare, responding to the report, told Hiqa the residents who were up and dressed early had chosen to get up at that time. The start time for cleaning staff has since been changed to 8am.
Prescription records indicated that residents who received night sedation were woken early in the mornings.
One of them – who was washed, dressed and sitting in the day room by 6.10am – had received two different types of psychotropic medication the night before. Inspectors also noted that a medication administration record indicated that a resident received a dose that was 50% higher than the dose clearly prescribed on the medication prescription sheet.
There was evidence that staff had reported the issue of removal of call bells from residents on a date last August, though the issue had been addressed by the introduction of a new call bell system. Hiqa says the issue has ‘not been adequately investigated’, though Mowlam Healthcare is understood to be conducting its own investigation into the unplugging of call bells.
Other concerns identified by Hiqa included an alleged incident of “suspected or confirmed” abuse of a resident on 26th August which was not reported to the authority until 30th October. 26th, 2015; and an allegation of poor wound care amounting to neglect of a resident.
The night-time inspection at the 101-bed Dungarvan Community Hospital on 25th September followed a high level of continual non-compliances noted during inspections in December 2014 and follow-up inspections last May and July.
On the night of 25th September, inspectors found that staffing levels in the evening and night time continued to be at the level of major non-compliance, with most units operating with one nurse and one care staff at night. The night nurse had to do the night time medication round and therefore this left only one member of staff to give out evening drinks and assist residents to bed and with other personal care needs.
At 6.30pm on the sunny Friday evening, inspectors found that the majority of residents in the centre were in bed and their curtains were closed. In the dementia specific unit, three out of the ten residents living there were in night attire before 6pm.