A resident in a Clare nursing home was left alone in an isolation unit after their requirement to be isolated had passed.
A Health Information and Quality Authority (HIQA) inspection found a “chaotic and disorganised” response to a Covid-19 outbreak at Cahercalla Community Hospital and Hospice in Co Clare.
The inspection, in late January, found all 12 regulations inspected to be non-compliant.
Poor infection control and institutional practices were observed at the nursing home.
The resident in isolation told inspectors that they were waiting to return to their usual room, but staff were too busy to organise this, however, inspectors were aware that, on the same day, there was an extra member of staff on that unit.
Lack of nursing supervision
Inspectors observed residents with complex health care needs associated with their diagnosis of Covid-19 spending extended periods of time alone in their bedroom with no evidence of clinical monitoring or nursing supervision.
Another resident told the inspectors that they were nervous when they had to mobilise to the bathroom alone as they felt very unsteady on their feet and there was no way to call for help if they fell when moving.
Other residents reported waiting extended periods of time for their call bells to be answered. Inspectors observed some kind and respectful interactions between staff and residents and, some residents reported that staff treated them with kindness and respect.
However, inspectors also observed staff speaking with residents in a disrespectful and abrupt manner and talking over residents, not giving them time to speak.
Privacy and dignity
Inspectors also observed a lack of awareness of institutional practices that impacted on residents rights to privacy and dignity.
“For example, inspectors observed a resident using a commode by their bedside with their bedroom door open,” the report reads. “The resident was unable to mobilise across their bedroom to close the door while they used the commode. This made it difficult for the resident to maintain their own continence in a dignified and respectful manner. Inspectors also observed a resident having lunch with an uncovered urinal sitting on the windowsill beside the bed table holding their lunch tray.”
The report concluded: “Not withstanding the restrictions in place during the Covid-19 outbreak, what residents told the inspectors and what the inspectors observed are symptomatic of a lack of insight into what constitutes a good service and a lack of supervision to ensure that staff deliver a good service. A greater focus on person-centred care is required.”
