HIQA INSPECTION REPORTS HIGHLIGHT EXAMPLES OF MAJOR NON COMPLIANCE BY SOME NURSING HOME PROVIDERS September 3, 2021

Key failings identified by HIQA during recent inspections of 45 residential centres for older people are deeply concerning and highlight that older people are not enjoying the quality of life and care they have a right to in some nursing homes, Sage Advocacy has said.

HIQA’s latest set of inspection reports, which show that inspectors found evidence of non-compliance in 25 out of 45 inspections, highlight that some nursing home providers did not meet national standards or adhere to regulations.

The national organisation, which provides a support and advocacy service for vulnerable adults, older people and healthcare patients, said nursing home providers must be held accountable for non-compliance issues.

Sarah Lennon, Executive Director, Sage Advocacy said: “The HIQA reports underline that there are unacceptable variations in the quality of care that some nursing home residents have received in Ireland.

“We have closely reviewed all of the latest 45 inspection reports and in some instances the care and support that nursing home residents had a right to receive was clearly lacking. It is understandable that both nursing home residents and their families will want assurances that these areas of non-compliance will be addressed by nursing home providers and that HIQA ensures that residents are treated with compassion and are safe and well cared for.”

Sage Advocacy said the latest set of reports demonstrate that HIQA inspectors uncovered significant failings in crucial areas by nursing home providers including infection prevention and control practices, residents’ rights and fire precaution requirements.

Other major issues of non-compliance detailed in the HIQA reports include instances where:

• There were not enough staff on duty to provide care and support in line with the residents' needs.
• A COVID-19 outbreak in a nursing home had not been fully reviewed to analyse the findings and possibly identify trends to establish learnings and positively influence their quality improvement strategy.
• Staff providing direct care to residents were also responsible for laundry duties and these duties were intermingled throughout the day.
• A COVID-19 outbreak review report had not been finalised by a nursing home following a significant outbreak and learning had not been actioned to date.
• In one nursing home ‘institutional practices’ ongoing in the centre impacted on the quality of the residents’ lives.
• Current premises in a nursing home did not ensure that residents had access to a sufficient number of shower/bathing facilities.
• Fire precautions were not compliant.
• Dietary instructions for residents were not always appropriately followed.
• In relation to fluid intake while residents' had full jugs of water in their bedroom they were not seen to be facilitated to access these.
• The monitoring and oversight of resident monies paid to the centre in respect of resident contributions towards additional costs were not adequate.
• Residents were not provided with records of all payments received and made on their behalf. This meant that residents were not informed or kept up to date regarding their finances.
• Improvements were required in the follow up to an allegation of abuse that was not fully managed per the centre's policy, and, the frequency of supervision of a resident had been reduced without completing any risk assessment.
• In one nursing home residents were not able to exercise choice in their morning routine. For example: residents thought they were required to get up before 08.30hrs and were not offered a choice of breakfast foods and were not aware that they could ask for something different if they wanted to do so.
• In one nursing home residents spent significant time in bed, or by their bedside with little or no social interaction, other than the daily activities going on around them. One resident said they felt they were 'forgotten'.
• Nursing home staff had incorrectly assumed a resident’s religion and their preference in music.

Ms Lennon said: “The latest HIQA reports do show that nursing home residents were well cared for and well supported by some nursing home providers, but this was not always the case and in some nursing homes there were major non-compliance issues which impacted on the quality of the nursing home residents’ daily lives.

“As a country we need to learn from the experiences of Covid-19 and we must ensure that people who live in nursing homes are safe and treated with compassionate.

“In the Programme for Government – Our Shared Future, the Government pledged to establish a Commission on Care and that this commission would “assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens”.

“We urgently need this commission to be established so it can immediately start examining the weaknesses in the current systems of health and care for older people”.