Buncrana Community Hospital receives mixed report from HIQA

The Health Information and Quality Authority (HIQA) carried out an unannounced inspection of Buncrana Community Hospital on April 30 between 10am-5pm. The inspection was carried out by Nikhil Sureshkumar.

The centre comprises two units, namely the main ward and the recently refurbished Ash ward, and is registered for 41 beds. The main ward can occupy 30 residents, whereas the Ash ward can occupy 11 residents. However, on the day of the inspection residents were only accommodated in the Main ward, and the 11 beds in Ash ward were vacant and not in use. 

The inspector spoke with some residents and visitors and their comments were generally positive.

The team at Buncrana Community Hospital received a mixed report. The staff were compliant with a lot of the requirements.

The levels and skill mix of staff at the time of inspection were sufficient to meet the needs of residents.

The inspector observed that those residents with communication needs were supported to communicate effectively. In addition, where a resident had any specialist communication needs, this information was clearly set out in the resident’s care plans and was communicated to staff.

Visitors were observed coming and going to the centre on the day of inspection. Visitors confirmed that visits were encouraged and facilitated in the centre.

The inspector reviewed a sample of care files, which indicated that comprehensive assessments were carried out with residents on admission to the centre. The care needs of residents were assessed at regular intervals

Residents had timely access to general practitioners and specialist medical and nursing services including psychiatry of older age, community palliative care and allied health professionals as necessary.

However, they had some areas where they needed to improve.

The HIQA report stated “The provider's management and oversight of the fire precautions in this centre was insufficient. For example, the provider had not effectively communicated the issue with the fire compartmentation to the relevant staff in the centre to ensure the safety of residents and staff.”

Overall, the care provided to the residents on a day-to-day basis was of a good standard. However, significant improvements were required to improve the physical environment of the centre and to ensure that residents were adequately protected in the event of a fire emergency

The residents were accommodated in the main ward of the centre in a mix of single, twin, three and four-bedded rooms. Although the four bedded rooms met the minimum size requirements HIQA was not assured that the layout of these rooms supported the needs of the residents who were living in them.

The building had some issues with leaks and the staff tried to assure the inspector that the issue would be resolved in a quick and effective manner.  Staff confirmed that the water leak near a chimney in a communal room in the Ash ward was a recurring problem. In addition, a bucket and towel were placed in a corridor in the Ash ward to collect any rainwater that may leak from the roof in that area during a heavy downpour.

Part of the main ward was a trip hazard with wheelchairs and other equipment being left along the side of the walls. 

Four multi-occupancy bedrooms were not suitably laid out to meet the mobility and transfer needs of residents using assistive equipment, such as hoists and specialist chairs. Furthermore, the layout did not ensure residents could carry out personal activities in private. 

The building was not adequately set up in case of a fire. Fire doors in three bedrooms, storage rooms and a clinical room in the main ward have intumescent strips missing, and these fire doors were not closing properly. As a result, the inspector was not assured that they could prevent the spread of smoke and fire in the event of an emergency. 

The inspector was not fully assured that the residents in this centre could undertake personal activities in private. A communal toilet in a corridor adjacent to the day room had a window that opened into this corridor, which was kept open throughout the day. As a result, the inspector was not assured that this arrangement would support and ensure adequate privacy and dignity for residents when using these facilities, as smells and noises could not be adequately contained.  Another communal bathroom in the centre's main ward did not have a door lock to ensure residents' privacy.

The management team at Buncrana Community Hospital have made some improvements.

Floor coverings identified have been assessed for temporary repair and will be completed by August 15. A new system of flat mop cleaning has been ordered and will be implemented by July 31. Repainting has commenced and will be completed by the end of July. Bedside lockers have been replaced. Bedroom doors and frames are scheduled for repair. Wheelchairs have been relocated to a storage area, away from the resident’s information area.

A fire risk assessment has been completed and was made available on June 28. Fire compartment plans are displayed throughout the building providing accurate and up to date information for residents, visitors and staff in the event of a fire emergency in the centre. All staff have been updated on the fire compartmentation and plans and are completing fortnightly fire drills.

Four multi-occupancy rooms have been reduced from four beds to two and three beds with the move of the short stay residents to the Ash Ward, thus allowing more space for residents. A review programme of the multi-occupancy bedrooms has been completed for a major refurbishment, commencing in 2025.