HIQA report raises concerns over hygiene and maintenance issues at Dundalk Care Centre

Dundalk Care Centre, a residential facility in Haggardstown registered to accommodate 130 residents, recently underwent an unannounced inspection by the Health Information and Quality Authority (HIQA) on September 30, 2024. The inspection, aimed at evaluating compliance with statutory regulations, revealed a combination of positive practices and significant areas requiring urgent improvement.

Inspectors gathered feedback from residents during the one-day inspection. Many residents praised the “kind and caring” staff while a visiting relative said “my relative is safe here and is very settled,” while another visitor said “staff are very good and always keep me updated.”

The quality of meals also received positive remarks, with the report commending the nutritional value and presentation of food.

However, a lack of engaging activities emerged as a major concern. Several residents described feelings of boredom, with one resident stating they were "fed-up just sitting here." At the time of inspection, only one healthcare assistant was allocated to provide activities for all 109 residents, significantly limiting opportunities for social interaction or personal engagement. 

The inspection report highlighted several maintenance and hygiene issues across the facility. Inspectors observed dirty and stained floors in bedrooms and corridors, as well as cobwebs and unclean equipment in some areas. Some rooms also had damaged walls with exposed cement and chipped paint.

The lack of adequate heating in certain areas was another issue. Inspectors noted that a dining room felt cold due to open windows, which staff closed following feedback. A resident reported sitting in a corridor because their bedroom was too cold, which inspectors confirmed upon discovering an open window.

Significant safety concerns arose regarding residents' access to emergency call bells. Inspectors found one call bell non-functional and another unplugged from the wall, leaving residents unable to summon assistance if needed. Management assured inspectors that a system-wide audit of call bells was underway, with new equipment scheduled for installation.

Medication storage was also found to be inadequate. Inspectors identified unsecured treatment rooms and medication presses, with one room’s door code visibly written on its surface. These lapses were flagged as breaches of safety protocols, increasing the risk of misuse or unauthorised access.

HIQA raised concerns regarding infection prevention measures. Inspectors observed unclean medical equipment, poor segregation of clean and dirty items, and improper disposal of clinical waste.

For example, one resident's bedroom contained two used urinary draining bags with the tip of the connecting tubes on the floor; in addition, the oxygen tubing used by the resident in this bedroom was on the floor.

Handwashing facilities, though newly installed, lacked essential supplies such as soap and paper towels, rendering them unusable.

Management practices at the centre also came under scrutiny. The inspection revealed that complaints were not handled in line with policy requirements, with some unresolved cases lingering for more than 30 days. Residents and their families expressed frustration over unresolved issues, such as an out-of-service coffee machine reported in early August, which was only partially addressed by the time of the inspection.

The report acknowledged proactive steps by management to address identified deficiencies. Regular resident meetings provide a platform for feedback, and some improvements, such as the introduction of new food service equipment, were noted during the inspection.

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Tempowell Limited, the registered provider, has outlined an extensive compliance plan to address these issues. Key measures include:

• Hiring additional activity coordinators to meet residents' social needs.
• Implementing enhanced cleaning schedules and conducting biweekly audits with external cleaning contractors.
• Improving maintenance oversight by increasing on-site staffing and implementing a robust task-logging system.
• Upgrading medication storage facilities to ensure security and compliance with regulations.
• Strengthening complaint handling procedures, ensuring all cases are resolved within 30 days as per policy.
• Conducting training for all staff on infection control and the proper use of clinical equipment.

Despite the concerns, the report recognised strengths in the centre's healthcare services. Residents have access to a range of medical professionals, including general practitioners, physiotherapists, and dietitians and monthly weight and health checks.

Additionally, staff interactions with residents were generally respectful and supportive, especially when managing challenging behaviours associated with dementia or other conditions.