HIQA flags governance issues at Donegal nursing home despite positive care findings

New measures have been put in place after a HIQA inspection raised concerns over management oversight and governance at a Donegal nursing home.

An unannounced inspection of Harbour Lights Nursing Home was carried out by the Health Information and Quality Authority in February found residents were happy, well cared for and felt safe, but identified gaps in how the centre is managed and monitored.

Inspectors found some areas of concern at the 56-bed facility in Killybegs.

HIQA judged the centre to be non-compliant in governance and management, highlighting issues around leadership structure and oversight.

Among the key concerns was a lack of clearly defined management responsibilities and insufficient clinical oversight. Assistant Directors of Nursing were not allocated dedicated management time and were instead working on the floor as staff nurses, limiting their ability to support effective supervision and monitoring.

Inspectors also found gaps in safeguarding knowledge among some ancillary staff, with a “small number” unable to demonstrate a clear understanding of safeguarding procedures, despite having access to training.

Further issues were identified in complaints handling and quality assurance systems. The complaints policy did not clearly identify responsible officers or set out proper timelines, while audits carried out in the centre failed to consistently lead to action plans or improvements.

“The lines of accountability and responsibility for management roles were not clearly defined,” the report said. 

“There there was no allocated time for the assistant directors of nursing to support the person in charge in the management and oversight of the centre, as they were working as staff nurses in the centre. 

“This lack of clinical supervision and support of staff and residents posed a potential risk to the delivery of a high-quality service and to the management of safeguarding within the service.

“The management and oversight systems in place to ensure the service was safe and consistent were not fully effective.”

Residents told inspectors they were “comfortable and happy”, with one saying: “I can’t complain, all is good here,” while another described it as “a relaxed, easygoing place.”

Inspectors observed positive relationships between staff and residents, with care delivered in a dignified and unhurried manner. Residents had freedom in their daily routines, access to activities such as music, bingo and arts, and opportunities to maintain links with family and the wider community.

The report also found the centre to be clean, bright and well-maintained, with suitable accommodation, communal areas and safe outdoor space overlooking Killybegs Harbour.

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Despite the concerns, the inspection concluded that residents’ rights were upheld, care plans were person-centred and regularly reviewed, and there were effective systems in place to protect residents from abuse.

In response, the provider has committed to a series of corrective actions, including allocating protected management time to senior nursing staff, updating complaints procedures, improving audit systems, and ensuring all staff complete safeguarding training by June 2026.

Some of these measures are said to be already in place.