UNACCEPTABLE: Residents ‘did not enjoy a good quality of life’

The health watchdog HIQA has issued a damning report following an inspection of the Sullivan Centre in Cavan Town.

The HSE run care home was classed as non-compliant in nine of the 15 criteria inspected during the unannounced visit on May 19 last. It only fully met standards in four of the areas inspected.

Located on Cathedral Road in Cavan Town, the Sullivan Centre provides 18 long-term care beds and two respite care beds for older adults who are mobile and those who have a diagnosis of dementia.

In the report, published last week, inspectors found that “residents living in this designated centre did not enjoy a good quality of life and were not facilitated to live the best life that they could”.

“Overall, inspectors observed an unacceptable institutional approach to care.”

Among the issues noted by inspectors Catherine Rose Connolly Gargan and Kathryn Hanly were an impact on residents’ quality of life and rights due to “unnecessary segregation of male and female residents, unacceptable restrictions on the movement of residents, limited opportunities for residents to engage in meaningful social activities and a physical premises that had limited comfort and personalisation”.

“Inspectors observed that interactions by staff with residents were predominantly focused on providing care interventions and there was limited evidence of person-centred interactions and conversations with residents.”

It was noted that only “a small number of residents” expressed satisfaction with the service they were receiving, while a larger number “did not engage either with the inspectors or with each other and their engagement with staff was largely around care interventions and medications”.

Distress

Some residents, with conditions such as dementia, were found to be in “distress” during the inspection, with little, if any, attention given by staff. This was despite inspectors bringing their concerns to staff.

“The inspectors observed one resident repeatedly trying to open a locked corridor door with a trolley and another resident repeatedly struggling to open the locked door to the secure garden at the side of the premises. “Although the inspectors alerted staff to one of these incidents, no staff intervention was observed to take place to support this resident and the resident's anxieties and distress increased. The two residents told inspectors that they were 'locked in' and couldn't 'get outside'.”

Restrictive practices

Residents on the male wing of the Sullivan centre were locked into the dining room during mealtimes. Staff claimed the practice was in place “to motivate residents to remain in the dining room and to encourage them with focusing on eating their meals”.

The majority of residents were also locked out of their bedrooms during the day, with no rationale given by staff as to why this practice was in place. Toilets and shower rooms were also kept locked and residents had to ask a member of staff for access.

Management and oversight of the Sullivan Centre service was not effective and the quality assurance processes in place did not ensure that the service was safe, appropriate and met the needs of the residents.

“Inspectors found that there was a culture of restrictive practices and daily routines that were negatively impacting on the lives of the residents.”

Staffing

Just four of the 10 actions required to be carried out following the previous HIQA inspection in February 2021 were carried out. This inspection was held on May 19, 2022.

While the level of staffing for the centre as a whole was deemed to be adequate, the splitting of it into two separate wings meant “the staff resource was not being used effectively”.

The inspection was carried out following a Covid-19 outbreak in January 2022. While it was noted this was the first significant outbreak of the virus at the Sullivan Centre during the pandemic, infection control and procedures generally were found lacking.

A soiled communal toilet was not cleaned for several hours and cleaning was only carried out when pointed out to staff by an inspector.

Weekly cleaning schedules were found to not be consistently signed, heavy dust was observed in the radiators in all bedrooms and underneath several beds and brown staining was observed on several surfaces in one bathroom throughout the day.

“Inspectors were informed by staff members that the contents of commodes/bedpans were manually decanted into the sluice and manually cleaned prior to being placed in the bedpan washer for decontamination. This practice should cease as it increased the risk of environmental contamination and cross infection.

“Inspectors observed that the detergent in the bedpan washer was empty. This negatively impacted on the efficacy of decontamination.”

Response

In a response to the report, furnished to The Anglo-Celt, the HSE said the report “noted that residents who spoke with inspectors expressed their satisfaction with the service they received”.

“Inspectors found that residents' clinical and nursing care needs were met to a satisfactory standard. Inspectors observed that the central garden was interesting and colourful and had been designed in consultation with residents.”

The HSE also says that action has been taken to address all areas of concern highlighted on the day of the inspection. These include residents now having access to all areas within the centre, deficits in relation to care planning have been addressed and additional training has been provided to all staff within the centre in relation to the provision of activities.

It also says “a person centred care and a programme of ongoing supervision and monitoring is currently underway within the centre”.

Martin Collum, General Manager for Older Persons Services HSE Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo said, “The HSE will continue to work to ensure that robust governance, quality and safety arrangements are in place within the centre to ensure high quality services are provided to all residents.”