Private nursing home in Laois fails in ten HIQA regulations

Another damning HIQA report on a large private Laois nursing home has found ten regulation failures, the poorest findings yet for the business.

The Residence Portlaoise, a three storey property built in Portlaoise town centre beside the railway line, only opened in late 2023.

The report comes a week after the shock closure of a family run private nursing home in Portlaoise, with residents having to find alternative accommodation.

Two previous inspections by the Health Information and Quality Authority (HIQA) had failed the nursing home in five regulations in each visit. HIQA had said last January in its previous report that "urgent action is required". However they have found continued non-compliance with previously failed regulations.

The newest inspection, carried out on February 12 and 13, found twice as many regulation failures.

They relate to supervision of staff, the management structure, complaints procedures, residents' care plans, and access to medical treatment and medical experts.

It found that 70 residents live in the Residence Portlaoise, up from 55 in the previous inspection of the 101 bedroom nursing home. 

The Residence Portlaoise nursing home. Image: Google Maps

While the inspectors report that the building is nicely furnished and clean, residents often must wait long periods for staff help.

"Two residents told inspectors that they frequently experienced difficulty in 'getting the attention of staff', either through using their call bell or calling out for assistance. They described how staff would respond to their call bell, but were interrupted during care to answer the call bells of other residents, or assist residents who were calling out.

"Residents told the inspectors that they would have to wait long periods of time for the staff to return and that they would have to use their call bell again to remind staff that they were waiting. Some residents said that while staff ‘were lovely and
did their best', there ‘was not enough of them to help everyone’, and they attributed this to the centre being short-staffed. Issues with this aspect of the service was also described by some relatives."

Residents also said that although they had listed their interests and hobbies on admission, they did not have the opportunity to participate in those activities.

Overcrowding was observed because residents are told to gather in only one of several day rooms, due to staff shortages.

"While there was a choice of comfortable and spacious communal rooms available to residents on each floor of the centre, residents were encouraged to spend their day in the ground floor day room, where staff would be available to support and
supervise them. This room was observed to be crowded over the two days of the inspection."

Families were not happy with their loved ones' access to healthcare.

"Overall, visitors were complimentary of the premises and the staff. However, visitors described how they were not satisfied with some aspects of the service such as access to health care professionals and timely access into the centre when visiting. They expressed concerns that staff were ‘always rushing’, and while they admired the ‘hard work’ of staff, visitors told the
inspectors that they often experienced long delays waiting to discuss residents' care needs with staff."

Read also: Shock as Portlaoise nursing home closes

HIQA inspectors say there is "repeated regulatory non-compliance".

"The findings of this inspection were that the provider had failed to implement the compliance plans submitted following previous inspections of the centre, and findings of non-compliance were repeated on this inspection, with regard to the
governance and management of The Residence Portlaoise.

"A weak organisational structure and ineffective management systems of monitoring and oversight continued to impact on the quality and safety of the care provided to residents. Inspectors found that, where the provider had implemented some systems to monitor aspects of the service including residents nutritional risks and access to health care, the provider failed to ensure that the implementation of those systems was consistent, effectively monitored and sustained.

"This resulted in repeated regulatory non-compliance in the regulations reviewed and impacted on the quality and safety of the care provided to residents.

"Inspectors reviewed unsolicited information received by the Chief Inspector. The information received pertained to concerns regarding the governance and management of the centre, the organisation and management of the staffing resources, and the quality of care provided to residents. This information was found to be substantiated on this inspection."

They say the overall governance and management has "deteriorated" rather than being improved since the previous inspection.

On staffing the inspectors found "it was unclear who held the responsibility for ensuring appropriate staffing levels were maintained in the event of unplanned staff leave."

"The provider had not appropriately identified the risk or contributing factors such as the high rate of staff unplanned leave or the high rate of weekly admissions to the centre. This impacted on the provider’s ability to identify, monitor and manage risks to residents' safety and welfare."

On food, "the registered provider had failed to identify the significant deficits in the care of residents who were assessed
as being at risk of malnutrition."

"Following the previous inspection on 24 October 2024, the registered provider was required to confirm the urgent actions they would take to ensure the safety and well-being of residents at risk of malnutrition. Inspectors found that, while the provider had developed systems to oversee the nutritional care needs of residents assessed as being at high risk of malnutrition, it had failed to ensure that these systems were consistently maintained and effectively implemented."

They say that "staff were not appropriately trained to deliver effective and safe care to residents. Staff were not appropriately supervised. 

There is repeated non-compliance on managing patient records, and also repeated non-compliance on individual care plans, and again on health care, such as access to dieticians. 

Complaints were not recorded. "For example, multiple residents and their families had reported dissatisfaction at the length of time it took to have the front door answered over a four month period in 2024."

Read also: Visitor restrictions continue at Portlaoise hospital over flu outbreak

The company has a response plan explaining how it is working to comply with the regulations, including giving more staff training, and hiring a new clinical nurse manager.

It says a monthly CAMEO Café began on March 1 with families and residents to raise awareness of complaints policy and to address any immediate concerns.