HIQA report finds eight areas of noncompliance at Dundalk nursing home

An unannounced inspection at the Dundalk Care Centre on the Inner Relief Road, Haggardstown carried out in February this year found the facility to be noncompliant when it came to eight separate regulations with particular concerns raised around staffing levels, according to a new report published by The Health Information and Quality Authority (HIQA).

The centre is registered to accommodate 130 residents all in single ensuite bedrooms and offers short term, long term and focused care options to residents.

At the time of the inspection, the centre was accommodating 52 residents. 

Inspectors observed that residents were well groomed, and that those spoken with said they received the assistance of staff with activities of daily living. 

However, some residents reported that the staff were extremely busy. 

The report noted that: “One resident told the inspectors that it was often nearly lunchtime by the time staff had time to assist them to get washed and dressed and they would prefer to be assisted earlier in the day. 

“Another resident said staffing at night was particularly poor, and said that nursing staff were overheard complaining that there were not enough nurses on duty at night, which was not nice to hear.

“The resident went on to explain that when the staffing levels were low, the staff on duty were not always in good form, as they were stressed and this was not nice for residents who relied on staff for company.”

The report says that staff spoken with confirmed that they were often short of staff. 

They told the inspector that there was a high staff turnover and they felt the high level of staff sick leave was due to the high demands of the job. 

On review of the roster on day two of the inspection there was just one staff nurse rostered to work on night duty, however, assurances were sought and gained that a second nurse was sought and rostered to work the night shift.

Inspectors further noted that the standard of nursing documentation was not of the required standard and drew attention to the fact that there was an absence of appropriate assessments and care plans for residents within 48 hours of admission. 

“The oversight of nursing documentation practices was insufficient,” the report said. 

The report also took issue with training practices at the centre, saying that: 

“Training was not adequately resourced. Staff had not completed mandatory training prior to commencing work in the centre or on induction.”

The inspection did, however, find that “residents’ rights’ were upheld.”

The report further said that residents spoken with said they were given choices in relation to food offered at each mealtime and also what activities they attended. 

“Residents described the food as excellent, they received a choice of meals and drinks. Inspectors observed the lunchtime dining experience, which appeared to be a relaxed event which residents appeared to be enjoying.”

“There was a lot of chat between residents and in some cases with staff, who were available to residents who required assistance.”

Inspectors also found that residents’ right to privacy was maintained, washing of laundry was done at a high standard and that a good choice of exercise and activities were offered. 

However, under the heading of Capacity and Capability, the report stated that “overall, this was not well-managed at the time of the inspection.”

The report also stated that management systems have not been implemented, that oversight of clinical care was poor, that policies were not implemented in practice and that there was an inadequate level of support provided to the person-in-charge to manage the volume of admissions.

On the issue of safeguarding inspectors concluded that: “The registered provider had failed to take all reasonable measures to protect residents from abuse.”

A case was detailed whereby two staff members whose names appeared on the staff roster did not have garda vetting in place. 

“One of these, was observed working beside another staff nurse on the orange corridor on the first day of this inspection," the report said. 

It continued: “This was discussed with the person in charge and the staff member was subsequently moved into an office. 

“On day two of this inspection their names had been removed from the weekly roster and inspectors were assured they were not on duty.”

Following the inspection, an urgent compliance plan was issued and a cautionary meeting was held with the governance and management team, where, the report says, assurance was sought and received from the provider that they would take immediate action to bring the centre into compliance. 

Overall, Dundalk Care Centre was found to be Substantially Compliant in four categories: Infection control, Fire precautions, Records and Premises.

The centre was found to be Compliant regarding regulations around Notifications of Incidents and Complaints Procedures.  

Finally, the care centre was judged to be Not Compliant in eight regulations, including; Staffing, Training and staff development, Governance and management, Written policies and procedures, Medicines and pharmaceutical services, Individual assessment and care plan, Health care and Protection.

Ultimately, HIQA required the Person In Charge to detail how these non compliance issues had been or would be rectified within a certain timeframe and these details were included at the end of the report.

Asked to comment on the report a spokesperson from Dundalk Care Centre said:

“At all times we are committed to delivering the highest possible standards expected by residents and their families through the rigorous implementation of our care policies and procedures. 

"We acknowledge HIQA’s report and findings, and note the positive feedback from residents reporting high standards of person-centric care being carried out by our experienced team. 

"Our newly developed home in Dundalk  was opened in September 2022, with many of the isolated recommendations cited in the report associated with establishing the home in the initial months of launch – including the staffing requirements it faced during that period.

"All staffing measures and recommendations from the report were quickly resolved at that time.

 “The team at Dundalk Care Centre are dedicated to ensuring our residents receive excellent person-centered care, and continuously working, not just to meet all current and new regulatory requirements, but more importantly to ensure a safe, bright, clean and comfortable home from home for our residents.”