HIQA inspections of residential centres for older people found that a number of centres did not comply with regulations or national standards this year.
65 inspection reports on residential centres for older people have been published.
While 21 were either fully compliant or substantially compliant, there was evidence of non-compliance with at least one regulation in 44 inspections, including at the HSE's Skibbereen Community Hospital in Co Cork.
The centre provides long-stay, respite, community support and palliative care to the older population of the town and the surrounding area and caters for the needs of 40 residents.
HIQA found that activities and social stimulation for residents was "inadequate".
"A large number of residents spent their day at their bedside or in one of the sitting rooms, with little to occupy them apart from daily care tasks and the television".
The report also states "There was evidence of institutional practices within the centre, some staff viewing the centre more like a hospital than a home for residents living in the centre".
A previous inspection of the centre by HIQA advised against multi-occupancy rooms.
This resulted in the construction of a new wing on to the hospital to accommodate people in single en-suite bedrooms.
However, the HIQA inspector found they were unoccupied.
Staff told the inspector they did not believe they had adequate resources to facilitate residents' relocation.
One member of staff told the inspector that it was more difficult to observe residents in these rooms and much easier when they were in multi-occupancy rooms.
Another member of staff told the inspector that these rooms would be more suitable for short stay respite residents.
Two residents that lived in shared rooms told the inspector they looked forward to moving into a new single room when they could, and they were aware they were not open yet.
The inspector observed that there were enough members of staff working in the centre to respond to the needs of the residents in a timely manner.
The report also notes that when it came to personal care and meals there were some positive interactions between residents and staff. However, the inspector also observed that some care in the centre was "task based".
While 80% of residents in the centre were living with a cognitive impairment and were unable to fully express their opinions to the inspector, the report does note that these residents appeared to be "content and relaxed in the company of staff".
It also says residents that spoke to the inspector said that staff were kind and came when they called.
Fairfield Nursing Home in Co Cork is also included in the reports published today.
An unannounced inspection occurred following "unsolicited information" which raised concerns regarding the standard of nursing care provided to residents living in the centre.
The report says that "some evidence was found to support the concerns received".
Management systems were not effective in ensuring the service was safe, consistent and effectively monitored and this resulted in poor oversight of the service.
Inspectors found that nursing staffing levels at night time, poor oversight of care planning and assessments impacted the safety and quality of care provided to residents.
HIQA says the provider had not identified risks with infection control and fire safety, which were impacting on the safety and well being of residents and staff.
These issues are all highlighted throughout the report.
Following the inspection, "a timely response" was received from the registered provider that provided assurances to the inspectors that immediate action was taken to improve the governance and oversight of the centre.
The provider also arranged for support to be provided to the person in charge from the sister nursing home following the inspection to assist with implementing the required improvements.
Ratoath Manor Nursing Home in Co Meath also received an unannounced inspection in September. At the time, the centre had an outbreak of Covid-19.
Two unsolicited concerns had been received prior to the inspection in relation to infection prevention and control practices and compliance with Covid-19
guidance, staffing and the standards of care delivery.
During the outbreak, 29 residents and 10 staff members tested positive for Covid-19 and all residents had completed their required period of isolation.
The report acknowledges that residents and staff in the designated centre had been through a challenging time.
Residents acknowledged to inspectors that staff and management had their "best interest" at the forefront of everything they did during the outbreak.
Inspectors observed the interaction between residents and staff and noted a kind, patient and positive approach on the day of the inspection.
However, management systems in place at the time of the inspection did not ensure that a good standard of service was provided for residents, according to the HIQA report.
It found that the systems in place to monitor the quality, safety and oversight of the service failed to ensure compliance with the regulation.
This is despite Ratoath Manor having a good history of compliance.
The report says there was a lack of effective leadership in the centre and this had resulted in inadequate practices.
HIQA inspectors found that the centre did not have an adequate number of household staff to ensure the centre was cleaned to an appropriate standard of the infection control regulation.
The inspectors found numerous gaps in the housekeeping rostered hours throughout the outbreak.
With the exception of four days, over the previous two weeks (prior to the inspection), there had been only two cleaners working across the three units of the designated centre.
The inspection report notes that given the spread and layout of the centre, this number was insufficient to clean the centre to an appropriate standard.