Failures: HIQA inspection report highlights 'significant decline' at Longford care centre

A HIQA report found there was a "significant decline in compliance with the regulations" at a county Longford care centre during the past year with eight areas non-compliant with expected standards.

Health Information and Quality Authority (HIQA) officials carried out an unannounced inspection of St Joseph's Care Centre on November 14, 2024.

The majority of residents spoken to were supported to live comfortably in the centre, however, their quality of life was impacted by significant restrictions in their environment and limited opportunities.

The centre was deemed to be non compliant in eight out of 15 regulatory areas according to the health watchdog,
Those areas were governance and management, residents' rights, staffing, training and staff development, individual assessment and care plan, health care, managing behaviour that is challenging and protection.

On the day of the inspection there were 57 male and female residents at the 24 hour centre of all dependency levels with most over the age of 65.

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The majority of residents spoken informed inspectors they were happy, content and satisfied with their daily routines and quality of life.

However, some residents stated they 'do nothing during the day', 'don't go out' and ' the day is long'.
Overall, the inspectors found that the service provided to residents was not aligned to the centre's statement of purpose and registration conditions.

HIQA found that there was a significant decline in compliance with the regulations since
the last May 2024 inspection and this was having a negative impact on residents' safety, care and supports, rights and quality of life.

This inspection found that management and oversight of this service was not effective and the quality assurance processes in place did not ensure that this service was safe, appropriate and effectively met residents' needs.

Inspectors found the quality assurance systems in place for monitoring the quality and safety of the service were "not effective and the quality assurance processes in place did not ensure that this service was safe, appropriate and effectively met residents' needs".

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The HIQA officials reviewed worked staff rosters and observed staff practices and found they "were not assured that the skill mix of staff available ensured adequate supervision and delivery of safe care to residents".

The report said this had resulted in poor care practices and limited opportunity for recreational or occupational activities for residents residing in the centre.

The inspectors said contingency plans to "cover staff shortages or leave were inadequate with inspectors identifying a number of days where units were left short staffed" due to sick leave.

The report found insufficient staffing levels resulted in poor oversight of staff practices which were negatively impacting on residents' care and wellbeing.

Under governance and management, the centre's oversight and management of risk was not effective and consequently, there were poor systems in place to identify, manage and respond to risk.

A 'failure' to ensure residents were appropriately safeguarded from risk of abuse was outlined including the risk of unauthorised access to the residents' environment by the public, which was not identified, assessed and effectively mitigated.

Despite improvements made by the provider since the last inspection to protect residents from risk of fire, the inspectors found that "action was required to ensure that storage of oxygen was appropriately risk assessed and risk of fire was effectively mitigated".

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The officials said improvements were required to ensure that a safe and good quality service for residents was provided, particularly in the areas of nursing assessments and care plans.

The centre was found to be 'substantially compliant' in relation to communication difficulties, premises, infection control and fire precautions and 'compliant' on statement of purpose, notification of incidents and visits.

A HSE spokeswoman said they welcome the findings of the HIQA inspection of St Joseph’s Care Centre which found 'the majority of residents' were happy, comfortable and satisfied with their quality of life.

"The unit was found to be fully compliant in three of the areas inspected and substantially complaint in four areas.

"Further areas assessed by the inspector were found to be non-compliant with matters in relation to the building and associated operations.

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"A compliance plan to implement the findings from the inspection has been agreed with HIQA and work is currently underway.

"The majority of the identified non-compliances have now been addressed with action plans in place to address all matters within the agreed timeframes.

"An oversight group has been established comprising of senior managers to support the governance systems to ensure sustained quality improvements,” she added.