HIQA raises concerns over staffing and governance at Louth nursing home

An unannounced inspection by the Health Information and Quality Authority (HIQA) at St. Peter’s Nursing Home in Castlebellingham, Louth has highlighted concerns around staffing levels, governance, and residents’ rights.

The inspection, carried out on June 23rd, 2025, found that while residents generally described the home as “a good and safe place to live,” ongoing staff shortages and weak management oversight were impacting the quality of care. At the time of inspection the home had 66 residents.

Relatives told the inspector that low staffing levels had led to delays in care and contributed to an increase in falls for one resident. Residents also reported that call bells were not always answered promptly. On the morning of the inspection, two care staff were off on unexpected leave, resulting in residents being left unsupervised for long periods until replacements arrived later in the day. When extra staff arrived the report noted, “ the impact was visible as residents were supervised and seen engaged in activities. The inspector observed a lively music session which was enjoyed by many residents”

The inspector observed examples of person-centred care but also noted rushed, task-focused practices. The inspector noted concerns that “residents were getting up and washed by the night staff, even when this was not residents' choice. Such institutional practices did not upheld [sic] residents' rights.” One resident expressed concern that they had been woken at 5 am to be washed and dressed.

HIQA also found issues with the physical environment of the nursing home. The internal smoking room had been converted into a storage space, leaving residents who smoked with no safe or sheltered area to smoke. “Five residents were observed smoking in the internal courtyards, however these areas did not provide shelter or the required fire safety equipment to ensure residents' safety.”

The inspector also noted worn flooring, damaged walls, and unkempt gardens, with no concrete refurbishment plan in place.

In the dementia care unit, residents were seen eating meals in the sitting room from small tables rather than being given access to the main dining area, a practice the inspector said “did not uphold their rights in the same way as it did for other residents.”

The inspector further remarked that, “Residents told the inspectors that the activities provided on a daily basis were ad-hoc and although a varied activity schedule was made available to them each week it was not always implemented in practice. In the absence of planned activities, residents could not make informed choices in respect of what activities they would like to attend and look forward to.”

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HIQA judged the nursing home “not compliant” in several key areas, including staffing, governance, premises, and residents’ rights.

However, the report also recorded positives: residents were well-groomed, staff had received safeguarding training, and care plans for managing challenging behaviour were in place. Garda vetting procedures and management of residents’ finances were also found to be robust.

In response, management at St. Peter’s Nursing Home has drawn up a compliance plan. Measures include having two full-time activity coordinators,  individualised activities assessments, maintaining the indoor smoking room, and introducing a supervision plan in communal areas. Flooring repairs and garden maintenance have already begun, while further staff training sessions are scheduled in the coming months.

HIQA has set deadlines for the home to address its compliance issues, with some improvements required by July and others by the end of September.