Dungloe Community Hospital 'is a well-run centre' but Hiqa non-compliance flagged

A Health Information and Quality Authority (HIQA) inspection found that overall the Dungloe Community Hospital is a well-run centre with clear management systems in place to ensure that the service provided is safe, consistent and appropriate to residents' needs.

However, the facility was found to be non-compliant on one aspect, with issues around the lay-out of some of the multi-occupancy bedrooms.

Dungloe Community Hospital is one of 11 community hospitals in Donegal. The centre is part of a one-storey building where a range of community services that include a day hospital, mental health services and out-patient clinics are located. Accommodation is provided for 34 residents. There are 17 places allocated for long-term care and the remaining places are allocated to residents who have rehabilitation, convalescence, respite or palliative care needs.

The unannounced inspection was carried out on Tuesday, February 27, 2024.

The inspector spoke with several residents during this inspection, and their feedback was highly positive about the care and service they receive in this centre. Some of the residents' comments were that ''this is an excellent place'', ''I am getting a five- star treatment here, ''the food is excellent and I get plenty of food'', ''the staff are kind and they will do whatever I ask'', ''they are a great team'' and ''I love the live music sessions".

The report said that the residents' well-being and welfare were maintained by a good standard of evidence-based care and support.

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However, the layout of the centre's multioccupancy rooms required additional improvements to ensure that these bedrooms met the needs of residents. The residents were accommodated in the centre in a mix of single, twin, three and four bedded rooms.

The inspector observed that if the dependency of a resident accommodated in a bed space of the twin room and three bedded rooms progresses, such as requiring larger assistive comfort chairs, the layout of these bed spaces would potentially become unsuitable to meet their needs and would impact on the privacy and well being of other residents in these rooms.

The inspector was also not assured that the layout of bedrooms with four beds supported the needs of the residents, and this is further detailed under Regulation 17. This was found to be non-compliant with issues relating to the layout of some of the multi-occupancy bedrooms.

For example, according to the inspector, the bed space near the wash-hand basin in two of the four-bedded rooms did not have sufficient space around the bed to enable the residents accommodated in these beds to mobilise safely and access their wardrobe or to use assistive equipment safely without encroaching on the next bed space.

This was because the bed was close to the wash-hand basin, and the arrangement of the privacy curtains to allow access for staff to use the wash-hand basin reduced the overall bed space, the inspector said.

The bed space adjacent to the en-suite in the three bedded rooms did not facilitate the safe use of assistive equipment and was not suitable for higher dependency residents who needed to use equipment such as specialist chairs, said the inspector.

The inspector observed that where residents accommodated in some of the multi-occupancy rooms and who were using large items of equipment such as a specialist chair or wheelchair kept their specialist chairs beside their bed, the circulating space around the bed was reduced.

Furthermore, the inspector said that some of this equipment was found to be encroaching into the neighbouring bed space.

Additionally, the premises did not conform to all of the matters set out in Schedule 6 of the regulations.

For example, there were insufficient storage space in the three bedded rooms for residents to store their photo albums and other valuables.

As a result some residents' photographs were placed on the wall behind their beds and were out of their view. Regulation 7 titled 'Managing behaviour that is challenging' was marked substantially compliant.

The provider had not ensured that, where restraints were used, they were used in accordance with national policy, according to the report. For example, appropriate alternatives had not been trialled for two residents before using lap belts.

Furthermore, the care records indicated that these two residents had not been appropriately monitored while lap belts were being used.

As a result, the inspector was not assured that the lap belts were being used for the shortest period to ensure the residents' safety, comfort and well-being.

The other regulations were all found to be compliant, and substantially compliant in both Managing behaviour that is challenging  and Governance and management - according to the report. The full report can be found here.