Just one staff member, a nurse, was on night duty to care for six highly dependent residents when a Health Information and Quality Authority (Hiqa) official inspected the Brothers of Charity-run Elm House in Mooncoin in September.
The lack of staff resulted in inspectors issuing an immediate action plan at the community-based residential centre, which caters for older people with moderate to profound intellectual disability and high dependency nursing needs.
Elm House is one of a number of designated centres that come under the auspices of the Brothers of Charity Services South East. This was the centre’s first inspection by the Authority.
The Hiqa inspectors found that residents’ dependency needs had increased significantly but staffing levels had not increased in line with this.
Staff shortage was causing a risk to residents, who were largely confined to the centre and had little access to outside activities or trips due to the inadequate staffing levels.
The centre operated with only one staff member from 11pm until 8pm and one resident who had been recommended to have three hourly turns at night to prevent the development of pressure sores had subsequently developed a sore when these turns could not be provided.
Inspectors issued an immediate action plan on staffing levels and were assured at the feedback meeting that extra staff would be made available on the night of the inspection.
Staff were extremely busy and unable to meet the assessed needs of residents on both days of the Hiqa inspector’s announced visit.
However it was noted that staff interacted with residents in a “respectful and dignified manner” and were knowledgeable about their individual needs.
There was no record of night-time fire drills which is particularly relevant as there was only one staff on duty at night time. In addition, two staff did not have up to date fire training.
Concerns were also raised about the suitability of the house for its residents, notably that corridors, the dining area and some bedrooms were too small to accommodate residents who require specialist chairs or mobility aids.
The inspectors found that there were large gaps in the bed rails which could pose a danger.