A nursing home in Co Kildare has been criticised by HIQA in relation to its management structure, staff training and care plans for residents.

A separate report on Leopardstown Park Hospital also found major non-compliance in terms of governance and management and safe and suitable premises.

The Health Information and Quality Authority said there was no clearly defined management structure at Hazel Hall Nursing Home in Clane and this impacted negatively on the overall governance of the centre.

Inspectors found that no senior manager had been identified to hold responsibility and accountability for all recruitment and retention processes, staff appraisals, performance management and supervision direction.

They also found that there was no evidence that full orientation, induction and required training was provided to all new staff to ensure the delivery of a safe and suitable standard of care to residents.

The report published today said moving and handling practices in the centre also required improvement.

The inspectors also found that care plans were not being implemented in full, in some cases because staff said the plans did not give them enough guidance.

During the unannounced inspection last June the inspectors found that the residents did have good access to nursing, medical and allied health care and the administration of medicines was satisfactory.

All interactions observed by the inspector between staff and residents were pleasant, helpful, respectful and patient.

'Management non-compliance' at Leopardstown

The report into Leopardstown Park Hospital found major non-compliance in terms of governance and management and safe and suitable premises.

It was also found to be moderately non-compliant when it came to complaints procedures, residents' rights, dignity, consultation and personal property.

The unannounced inspection took place on 4 September this year. It was the eighth inspection of the centre that identified an unacceptable level of regulatory non-compliance.

While it said that the registered provider had made some improvements, it had failed to address issues identified in the cleaning and upkeep of four areas reviewed. Inspectors found that bed spaces, toilet and shower facilities were unclean and unhygienic.

Inspectors found that the layout and design of the dementia-specific unit was clean.

The report says while inspectors found some improvements had been made to the layout of four large wards, when personal and intimate care was carried out at residents' bedsides there was still only a screen dividing the beds which did not block out noise or odours.

It says the proximity of some beds to one another resulted in a risk of infection control and cross contamination.

Inspectors also found that there were still foul odours coming from toilet and shower facilities. It says the standard of cleaning of the facilities in three of four areas inspected was "unacceptable" with organic matter noted on multiple surfaces.

The report says that a deep clean has been carried out on the units and a cleaning supervisor has been assigned on a full-time basis to cleaning supervision.

The number of beds in the four units have also been reduced which has allowed for creation of additional space.