The inspection of Bushfield Nursing Home in Oranmore, Co Galway, followed a previous visit when it emerged a month earlier in June that some residents were going hungry as portion sizes were too small, leading to orders for urgent action.
“Inspectors found that, once again, failure to pay suppliers in a timely manner had resulted in an interruption of the gas supply to the centre,” said the report of the Health Information and Quality Authority (hiqa).
“The impact of this was that residents had no access to hot water for one full day and showers could not be offered and facilitated. Cooking, heating and laundry services in the designated centre were also gas powered.”
Inspectors noted that little progress had been made in relation to on-going fire safety works since the last inspection. An area of the centre remained boarded up and could not be accessed internally.
In addition, a review of the operating bank account of the centre found that there was insufficient funds available to ensure a sustainable and safe service.
Inspectors were provided with records of the operating bank account for the designated centre.
“A review of the record of this bank account found that, on the days of the inspection, this account was nearly empty. Of further concern was that monies, totalling over €3,000, belonging to residents held by the provider in the operating bank account was not available to the residents,” they said.
“The registered provider could not be contacted during this inspection to give assurances that the residents money would be available should any resident request the return of their monies.”
The report revealed that “following consistently poor regulatory compliance over repeated inspections in March, May, and June 2024 in relation to governance and management, food and nutrition, record management, and protection of resident’s finances, on 14 June 2024, the Chief Inspector of Social Services issued a notice of proposed decision to cancel the registration of the centre”.
“The registered provider made representation within 28 days of the notice being issued, to detail the action that had been taken to address the non-compliance relating to the resources available, the systems of governance and management, and the quality and safety of the service. The detail of this representation was reviewed on this inspection.”
Records reviewed found that residents were being charged for services that they did not avail of. A review of the care records for one resident found that the resident had been charged for physiotherapy services which they had refused on at least two occasions.
“Residents did not have ’24/7 access’ to monies held for them within the designated centre petty cash system, as described in the providers’ representation. Access to funds was only available when the person in charge or the house manager were on duty. Rosters reviewed confirmed that these managers were not rostered to be in the centre at weekends, evenings or night-time. The staffing in the centre on the days of the inspection was adequate to meet the needs of the residents,” the report said.
“A number of staff were not aware that some residents were at risk of malnutrition.”
In its response, Bushfield Nursing Home Ltd provided a compliance plan to address the issues which were highlighted by the inspectors.
A second inspection of Archersrath nursing home in Kilkenny, owned by Mowlam Healthcare, found it had an outbreak of norovirus, the winter vomiting bug.
“The majority of residents were observed to be isolating in their bedrooms and were not accessing communal spaces or group activities on the day of inspection,” the report said.
Inspectors observed signage in one sluice room which advised staff to empty the contents of urinals and commodes prior to placing them into the bedpan washer for decontamination.
“This practice posed a risk of cross infection. Barriers to effective hand hygiene practice were also identified during the course of this inspection.
“The inspectors observed that there were a limited number of dedicated clinical hand wash sinks available for staff use. Additional dispensers or individual bottles of alcohol hand gel were required to ensure alcohol hand gel was readily available at point of care -directly outside or inside every bedroom.
“The medication fridge was also visibly unclean. Several bedrooms and bathrooms were visibly unclean.
“The feedback from residents was that they were happy with the care provided, expressed satisfaction with staff, and food served.”
In response, the owners have submitted a compliance plan to address the issues.
