The Health Information and Quality Authority has found that a Health Service Executive-run facility for people with disabilities could provide no written evidence that residents or their families had been consulted before it decided not to medically resuscitate three residents.
The watchdog's report on the Cherry Orchard Hospital campus in west Dublin also found that no action had been taken to address several incidents where financial abuse of residents could have occurred.
The report relates to an unannounced inspection of the centre last January.
Two months earlier, HIQA had threatened to close the facility, which is home to 25 men and women with disabilities, because of persistent failures to maintain standards, but the HSE had promised to bring it in line with regulations.
However, January's inspection found that 86% of the breaches discovered in November were still evident, prompting HIQA to, as it puts it "escalate regulatory action with the HSE".
Inspectors examined three residents' files, which instructed that none of them was to be resuscitated.
They found that the process that led to this decision was unclear as no documentary evidence was available in relation to discussions with family members, apart from the statement that they had taken place.
There was also no evidence that the wishes of the residents concerned were respected in the process, even though inspectors were assured that all three of them would be able to participate in such a discussion.
Inspectors also found that no action had been taken following an inspection two months earlier where sums of residents' money were unaccounted for.
They were told a new system had been put in place days earlier to record residents' finances, but when evidence of this was requested, the recording book was blank.
This afternoon, the HSE said that its residential centre on the Cherry Orchard Hospital campus has completed 92% of actions which HIQA has required it to take on foot of two highly critical inspection reports.
In a statement to RTÉ News on yesterday's report, HIQA said that 8% of the remedial measures are still outstanding.
The statement makes no reference to the placing of Do Not Attempt Resuscitation instructions on the files of three of the 25 residents without any written record being made of discussions the facility's management said it had conducted with the residents concerned and their family members.
The HSE have been in on-going engagement with HIQA in regard to the facility that the watchdog was "satisfied with progress of same at the most recent meeting last month.
The statement also notes that HIQA has issued a completion date of the end of next month "for Cherry Orchard Hospital to reach 100% compliance" in respect of both units which comprise the centre.
Responding to the report, the Irish Patients' Association called on the Minister for Health Simon Harris to reassure the public that nursing homes around the country are not copying the practice.
The IPA's chairman, Stephen McMahon told RTÉ News that it was "shocking" that the HSE had failed to follow its own National Consent Policy.
Mr McMahon also called on the incoming Director General of the HSE to reassure the public that HIQA's discovery at the Cherry Orchard Hospital campus was an isolated incident.
He said the issue needs to be teased out to ensure that the high standards the public expects are being adhered to everywhere.