Good quality care but HIQA non-compliance remains at Donegal Community Hospital

A Health Information and Quality Authority (HIQA) inspection found that patients in Donegal Community Hospital received good quality care and felt safe and well-treated by ‘pleasant and kind’ staff.

However, the HSE-owned facility was found to be non-compliant with a number of regulations including infection control, premises, residents’ rights, and medicines and pharmaceutical services.

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It was noted that fire safety works are progressing as per a previously agreed phased plan.

Donegal Community Hospital is a purpose built two storey building on the outskirts of Donegal Town. The residential part consists of a 29-bed ground floor unit, providing palliative care, respite care, convalescence, rehabilitation and continuing care. The provider is restricted from admitting long-term care residents because of the limitations of the lived environment.Accommodation comprises seven single bedrooms (six en suite), one en suite twin bedroom and five multiple-occupancy bedrooms, each accommodating four residents. There are two sitting rooms, a dining room and an oratory for communal use. 

The designated centre includes a treatment room, staff facilities, a small laundry and a main kitchen.

The report published on January 31 related to an unannounced inspection on May 8. There were 21 residents present.

According to HIQA: “Overall, the inspector observed that the nursing and health care provided to the residents was of good quality, and the residents' feedback was generally positive.

“However, significant actions were required to improve the lived environment for the residents and to ensure residents had access to meaningful activities in line with their abilities and preferences.”

Residents told the inspector that the staff were very pleasant and kind and that they felt safe in

their home. Many residents commented that the food provided to them was of good quality and that staff asked about their food preferences on a daily basis.

The inspector noted: “Call bells were responded to promptly, and staff attended to the needs of residents in a timely manner. Staff followed safe people handling practices while assisting residents for their care needs.

“Staff interactions with residents were respectful and empathetic.”

The inspector noted that there were not enough communal toilets for residents' use should they wish to use toilets other than their en suite facilities, which is a repeated finding from the previous inspections.

“Furthermore,” the inspector reported, “the layout of some twin-bedded rooms did not uphold the dignity and privacy of each resident accommodated in these rooms.”

The inspector was informed that the next phase of refurbishment works planned for the centre would seek to address the layout of the multi-occupancy rooms and improve infection control facilities. However, there was no start date for this work.

Equipment storage was a cause for concern, with wheelchairs, mattresses and unused hoists stored along some sections of the centre's corridors, posing a risk to residents who were mobilising in these areas. 

Residents were observed to spend long periods with little to do. This was validated by staff and residents who confirmed there were no activities scheduled, and care was focused on rehabilitation. 

The inspector observed that the dining area was not arranged to facilitate a good social experience for residents. 

“The dining arrangements encouraged residents to have their meals served in their bedrooms,” the inspector reported. 

However, there were three residents who told the inspector they would prefer to have their meals in the dining room so that they could enjoy the opportunity to socialise with other residents in the dining room. This feedback was brought to the attention of the management team, who made changes to the evening meal arrangements in order to facilitate residents who wished to do so to have their evening meal in the dining room.

Overall, Donegal Community Hospital was found to be compliant with regulations relating to: training and staff development, communication difficulties, health care, visits, and protection.

It was substantially compliant in: staffing, and managing behaviour that is challenging.

The facility was deemed non-compliant in areas of: governance and management, personal possessions, premises, infection control, individual assessment and care plan, residents’ rights, and medicines and pharmaceutical services.

The full report can be found here

Following the publication of the report, the HSE issued a statement saying that additional refurbishment work is due to commence in February as to ensure compliance with Infection Prevention and Control standards.

All care plans have been reviewed and a Social Care Activities Programme has been developed to meet the resident’s needs. The activities schedule is now provided for seven days per week.

Melissa Kelly, Acting General Manager for Older Persons Services HSE Community Services, Cavan, Donegal, Leitrim, Monaghan, Sligo said: “The HSE will continue to work to ensure the delivery of high quality, person centered services to the residents in Donegal Community Hospital.”

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