Improvements required in three residential centres in Donegal

The Health Information and Quality Authority has published 32 inspection reports on residential centres for older people.
In Donegal, unannounced inspections were carried out at 3 centres, all of which have been found to require improvements to the premises.
They are the Sheil Hospital, Ballyshannon, Buncrana Community Hospital and the Rock Nursing Unit, Ballyshannon.
Inspectors found Buncrana Community Hospital to be compliant in all regulations apart from premises.
The inspector says the design and layout was not suitable for purpose and multi-occupancy rooms did not provide adequate private accommodation which was a repeated non-compliance from previous inspections.
Records from the Sheil Hospital, Ballyshannon state that less than 50% of staff had attended
training in dementia care and the management of responsive behaviours.
In addition, inspectors said responsive behaviours care plans did not provide sufficient details of triggers for behaviours or the appropriate de-escalation interventions required. Improvements were also required in how restraints were used.
The premises was found to not meet the needs of residents in terms of the layout and size of a number of single and twin bedrooms, no quiet space for residents to meet visitors and the communal lounge and dining room did not provide enough space for 16 residents.
The registered provider was found to not have taken adequate precautions to ensure external fire escapes provided a safe means of exit and that fire drill records did not provide assurance that staff would be able to carry out a safe horizontal evacuation within an acceptable time frame.
HIQA found that the layout of multi-occupancy rooms at the Rock Nursing Unit, Ballyshannon especially rooms acting as an access route between other parts of the building did not ensure the privacy and dignity of residents could be met at all times.
In relation to staffing, the report says the numbers and skill mix of staff were not appropriate to the assessed needs of residents and the size and layout of the centre, particularly at night time.
The registered provider did not provide sufficient resources to ensure the effective delivery of care to residents, particularly in relation to adequate staff being available at night to ensure that fire safety measures such as evacuation could be undertaken in a safe and timely manner.
As part of the urgent action plan issued, the inspector requested that a fire evacuation drill of the whole compartment be carried out with the revised night-time staffing levels.
Improvements were also required to ensure care plans were personalised so that in the event of changing needs and circumstances the care plan guided staff interventions.