HIQA inspector gives HSE nursing home in Laois a glowing report

In contrast to the multiple regulation failings of The Residence private nursing home in Portlaoise, the HSE has shown how it can get things right by properly funding community nursing units.

St Vincent's CNU in Mountmellick is the largest of the three HSE owned nursing home facility in Laois, with 55 residents, and a 50 ensuite bedroom extension almost complete.

The HIQA published results on Monday June 22 of an unannounced inspection carried out on March 6.

Inspectors found that St Vincent's complies with nine regulations. It is substantially compliant with a further three; related to quality of records, care plans and management.

HIQA said however that “governance and management was organised and the centre was sufficiently resourced to ensure that residents were supported to have a good quality of life”.

It found that there are enough staff employed for the number of residents and size of centre.

"On arrival to the centre, the inspector was met by residents that were out walking the corridors for some exercise. The residents opened the door for the inspector and chatted freely about life in the centre and expressed a high level of satisfaction with the service provided. This positive feedback was echoed by all residents and visitors spoken with throughout the day. Without exception, the residents praised the staff delivering the care as individuals and as a group.

“When asked how they passed the day one resident told the inspector there was plenty of choice and that they 'hadn't time to be bored'.

“Residents' personal clothing was laundered on-site. Residents expressed satisfaction with the service, and described how staff took care with their personal clothing and returned it promptly to their bedroom.

“The inspector observed that staff were kind, patient, and very attentive to residents' needs. While staff were seen to be busy, they were observed to respond to residents' requests for assistance promptly and in an unhurried manner.

“The communal rooms on each unit was supervised at all times with staff in attendance to respond to any requests. Staff who spoke with the inspector were very knowledgeable about residents and their needs.

“The inspector observed that personal care was attended to a very good standard. There was a pleasant atmosphere throughout the centre, and friendly and familiar chats could be heard between residents, visitors and staff.

“Residents spoke positively about their experience. They said staff respected their choices and treated them with dignity and respect. Residents said that they felt safe, and that they could freely speak with staff if they had any concerns,” HIQA said.

The residents are brought on local shopping trips, scenic drives and to the local panto. They can also walk in several secure gardens in the centre.

"Residents could access the expertise of allied health care professionals such as dietetic services, and speech and language therapists through a system of referral. However, residents were not always appropriately referred for further expert assessment when clinically indicated," HIQA said.

"All areas of the centre were observed to be visibly clean and tidy and the premises was generally well maintained. On-going maintenance was in place. Significant improvements had been made with the purchase of new furniture that gave the
communal rooms a homely feeling. There was a cleaning schedule in place to support the systematic cleaning of all areas of the centre.

"A safeguarding policy provided guidance to staff with regard to protecting residents from the risk of abuse. Staff demonstrated an appropriate awareness of the centres' safeguarding policy and procedures, and demonstrated awareness of their responsibility in recognising and responding to allegations of abuse. Residents reported that they felt safe living in the centre.

"Residents' rights were promoted in the centre. Residents were free to exercise choice in how to spend their day. Activities were observed to be provided by dedicated activities staff. Residents told the inspector that they were satisfied with the activities on offer. There were opportunities for the residents to meet with the management team and provide feedback on the quality of the service. Resident meetings were held on every unit and any matters arising were then escalated to the person in charge for them to follow-up.

Residents had access to an independent advocacy service. The inspector observed that there were information leaflets on local amenities within the community, strategically placed around the centre.

Read also: 'The town needs a kickstart' reaction to Mountmellick draft town centre first plan

"Visitors were openly welcomed in the centre and residents were happy with the arrangements in place. There was a risk register which identified risks in the centre and the controls required to mitigate those risks."

However St Vincent's must still improve, as the HIQA inspectors found a low risk lack of oversight of residents, putting them at possible risk of malnutrition. They say that care plans must be written within 48 hours of admission. 

In response to the three 'substantially compliant' findings, the HSE gave details on how it has amended its procedures to fully comply with regulations. 

The community nursing unit is planned to get another 80 bedrooms, all ensuite, in two phases of future expansions.

It is ten years since HIQA banned admissions at the Mountmellick hospital because its large wards did not comply with single bedroom regulations. A year later, in 2016, when the ban was lifted, the then Laois TD and Minister Charlie Flanagan announced funding of €23.7 million for a 130-bed unit.

The HSE also owns Shaen hospital nursing home, as well as Abbeyleix CNU which is now a step down and respite facility with 22 beds.