RESIDENTS AT a Health Service Executive centre for older people in Co Mayo were not given rehabilitation after suffering strokes and did not have adequate access to speech and language therapy, according to a report from the Health Information and Quality Authority.
The report on the Sacred Heart Hospital in Castlebar said patients with pressure sores were not given adequate treatment and some residents who had decaying teeth were not referred to a dentist.
Built in 1973, the hospital can accommodate 144 residents for long-term, convalescent, respite, rehabilitation and palliative care. Some residents had dementia, acquired brain injury or intellectual care needs and, at the time of inspection, six were under 65.
The inspection took place over three days in May and the report was published just before Christmas.
Inspectors found “many residents” with disabilities related to strokes did not have access to the rehabilitative therapies. Inspectors highlighted one resident, who had a stroke and was ambitious to go home but who had no rehabilitative programme in place.
“Inspectors noted that his affected arm hung unsupported for prolonged periods as it tended to slip off the pillow as he moved around in his wheelchair,” the report said.
There was a lack of sufficient healthcare to support the needs of residents with complex medical conditions, the report said, including “a lack of speech and language assessment” for residents with swallowing difficulties. There was also a lack of access to chiropody for bed-bound residents.
The report also said wound care management was not in line with contemporary practice. Five residents had pressure-related sores, and two cases were very serious. And some residents with pressure sores were not being turned as frequently as they should have been.
There were insufficient numbers of showers and toilets in two of the three units within the hospital and “all aspects of infection control and prevention practices were not of an adequate standard throughout the centre”.
Equipment used by residents was not in a clean condition.
“Inspectors noted that commodes were rusted but also heavily soiled; sinks and surfaces in the sluice rooms were not clean,” the report said.
It also found care planning, nutrition, falls management, wound management and end-of-life care and medication management all required improvement.
There were few opportunities for creative or recreational fulfilment, which resulted in “residents sitting around for long periods without any form of stimulation”.
Governance was described as weak in a number of areas and the HSE recruitment embargo meant many work shifts were not covered at the facility, the report said.
In response to the findings, the HSE said staffing was being re-evaluated at the facility.
A chiropodist and a speech and language therapist had been assigned to the hospital and the referral system for physiotherapy was being monitored.
Training was also being provided for staff in areas including infection control, challenging behaviour, care plan completion, restraints policy and wound management, to be completed by June this year.
Improvements in the delivery of meals had been implemented. In addition, a maintenance plan for the hospital was commenced in October to be completed this February.
Residents’ commodes were “sufficiently maintained to ensure they are in a clean state at all times”, the HSE response said.
There was also a review of activities for residents, including individual assessments and additional reflexology for residents who spend a lot of time in bed.
