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Daytime nurse staff numbers criticised at Mowlam

A Special Report


NURSE STAFF numbers during daytime at a Sligo town private health care facility in July were criticised as inadequate by the statutory standards watchdog.

The numbers of nurses rostered during the day could "compromise the delivery of safe clinical care," the standards watchdog said.

There were two staff nurses for 57 patients and "this could not ensure the care needs of residents was maintained fully at all times."

It is the most significant finding in the report released online by the Health Information and Quality Authority (HIQA) yesterday evening, Tuesday.

The HIQA inspectors said they made the observations after observing practice reviewing rosters and taking account of the dependency needs of of patients, in line with the 2007 Health Act.

The unannounced inspection took place seven weeks ago at the facility on the north side of Sligo town.

Sligo Nursing Home is situated at Ballytivnan and owned by Mowlam Healthcare.

The private home employs 52 staff, which in whole-time equivalents (WTE) breaks down as nine nurses and 24 care assistants, the HIQA assessment states.

The HIQA report released online yesterday evening contains a commitment by the Mowlam Healthcare management to recruit a Clinical Nurse Manager and a staff nurse by September 30th.

The Inspectors noted that on their visit there were 19 residents aged 90 years or over and a further 10 were over 85 years or over.

Residents overall among the 57 had a wide range of care needs and, said HIQA, some had "complex medical conditions."

HIQA made its unannounced inspection of the Sligo site on July 26th 2012, according to details published online yesterday evening (Monday).

This was the fifth inspection at the home, to monitor compliance with registration requirements.

The lead inspector was PJ Wynne, with a support inspector Mary McCann also in attendance on the Sligo visit.



Not Satisfied


HIQA said that there was a suitable number, and skill-mix of, staff on night duty in the home at Ballytivnan.

However, "the inspector was not satisfied that sufficient nursing staff level was available through the daytime.

"There were two nurses rostered for duty most days each week to meet the care needs of 57 residents accommodated over two separate floors.

"On the day of the inspection a small number of residents were very unwell and required additional attention."

The HIQA inspection ruled: "The demands on nursing staff at peak times during the day had the potential to compromise the delivery of safe clinical care and did not ensure the care needs of residents was maintained fully at all times."

The 32 page report (see link below) scored the Sligo nursing home for praise in a range of other items on the HIQA checklist of 18 items.

Sligo Nursing Home scored well in comments on its management team, the building layout and its safety features, staff communications with patients, rights of family and patient privacy and dignity, a clean and organised laundry, food safety systems and training of staff.


Comfortably Warm


The inspection in July noted a comprehensive medication management policy -- with photographic identity on drugs chart for each patient --

''The layout, furniture and decor are coordinated, bright, clean and modern,'' said the HIQA inspection report. Bedrooms were described as spacious "and comfortably warm."

It added: ''There was evidence of quality improvement strategies and monitoring of the services,'' with HIQA noting that it inspected the audits of such activity.

Garda vetting was in place for all staff but it was noted that training had not been provided in two key areas.

"A review of training records," said HIQ, "indicated 10 staff recruited since the last inspection were not trained or formally educated in adult protection."


Risk Assessed


Five members of staff had not received annual fire safety training, the HIQA inspector noted after examining records.

The inspection noted heat and smoke detectors were in place and records showed these were checked and serviced.

"Each resident has been risk assessed to indicate the equipment required to safely evacuate the residents in the event of fire or other emergency situations," the report added.

Staff facilities in the purpose-built two storey block were praised by HIQA, but it was noted that the cleaning room had no external wash hand basin for staff, ''inadequate ventilation'' and a fan was observed not to be working.

Link to full HIQA Report: http://www.hiqa.ie/social-care/find-a-centre/inspection-reports

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