Report reveals 'serious risks’ at Laytown nursing home

An inspection of a County Meath nursing home has found that there were serious risks to the health and welfare of residents due to the failure of the provider to meet acceptable standards. The inspection of Creevelea House Nursing Home, Laytown, was carried out by inspectors of the Health Information and Quality Authority (HIQA) who found neither the requirements of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 (as amended) or the National Quality Standards for Residential Care Settings for Older People in Ireland had been met. The inspection was a “triggered, unannounced†check in response to information received by HIQA and took place initially over a two-day period. Concerns were raised by a former resident and HIQA revealed 34 separate breaches of the statutory regulations which were considered so serious that the service provider was called to a meeting with the inspectors at HIQA. There were concerns that the provider failed to provide adequate care and attention to a former resident prior to his discharge, including the competency of staff to identify signs of deterioration in the resident's condition and manage them appropriately. The inspectors said they had “significant concerns for the care and welfare of residents†at the nursing home, which can cater for up to 44 residents but had 31 in residence during the inspection. The HIQA report said residents at the home suffered 19 falls over a six-week period and received a poor level of care that resulted in serious risks to their health. In one incident, a resident who had broken her leg after a fall was subjected to an “invasive and inappropriate procedure†resulting in an anal tear. Another resident, who regularly refused food, developed a pressure ulcer and did not receive appropriate care. The inspection took place over five days in March and April last. The inspectors pointed out that there was no-one in charge of the nursing home during the inspection process, which resulted in a lack of leadership and support for staff. There was no evidence of ongoing monitoring of the service, there was inadequate food stocks, the centre was draughty and poor standards of hygiene were observed. HIQA found that insufficient precautions had been taken to manage risks, specifically in relation to accidents. There was also a lack of supervision of residents assessed at being at risk of falls. The inspectors reported that there had been 19 falls over a six-week period, one of which was serious and resulted in a fractured hip. None of these incidenrts had been notified to the authority, the report states. They said that staff levels, supervision and skills mix were not appropriate to meet the healthcare needs of the 31 residents at the Laytown centre. One inspector checked one resident who could be heard calling for assistance. On entering the room, the resident was asking to get up; there was a strong smell of urine and the resident's mouth was dry. “This was brought to the attebntion of care staff who, when asked if the resident had been offered anything to drink since breakfast, responded “No, when she is like this, she refuses everything,â€, the report added. Concerns were brought to the attention of the provider, Peter Murphy, and an interim contingency plan was agreed. When inspectors returned to the nursing home on 13th April, they found the plan had not been fully implemented. Mr Murphy was subsequently summoned to a meeting with the HIQA inspectors, who made 34 recommendations to enable the home to meet the statutory regulations. In his response to the inspection, Mr Murphy said that the provider had “endeavoured to promptly address all matters where clear written guidelines and recommendations have been communicatedâ€. He added: “Staff are to be commended for their commitment.â€