Staff shortages, inadequate fire safety procedures and the poor conditions of premises have been highlighted in the latest nursing home inspection reports by the Health Information and Quality Authority.
Evidence of non-compliance was found in 32 out of 49 inspections carried out, including at a number of homes run by the HSE.
Plunkett Community Nursing Unit in Boyle, Co Roscommon, is a purpose-built facility that can accommodate 38 residents with a range of needs.
During an unannounced inspection in May, inspectors found the centre had not maintained a high standard of cleanliness to provide a safe environment.
They observed practices that were not consistent with national standards for infection prevention and control in community services.
Equipment such as shower chairs and wheelchairs were not appropriately cleaned and decontaminated after use.
The report notes equipment "observed to be heavily soiled with organic matter".
The laundry area did not provide for division of clean and dirty areas as required by national guidelines.
Bedrooms that had been signed-off as deep cleaned were not clean on inspection, according to the report.
Plunkett Community Nursing Unit had a fire safety policy and associated procedures to guide and inform staff in the event of fire alarm activation.
Worryingly, the fire procedure displayed throughout the centre was not accurate or consistent with the information it displayed.
Instead, according to the HIQA report, a postal code for the centre to be given to emergency services in the event of a fire was for a premises in Co Galway.
A number of the HSE premises inspected by HIQA were found to be non-compliant under a variety of headings.
At Youghal Community Hospital in Co Cork, inspectors found a bath inaccessible because the room was used for the excess storage of hoovers, buffers, hairdressing equipment, wheelchairs and a hoist.
At Merlin Park Community Nursing Unit 5 & 6, many of the multi-occupancy bedrooms impacted negatively on privacy and dignity of residents living there.
There were two showers available for residents occupying the 12 single bedrooms in one unit, but they were located on the opposite side of the main corridor.
One of the shower rooms was located "a substantial distance away" from the bedrooms and residents were required to pass through communal spaces which affected their choice, privacy and dignity.
Inspectors also found there was no dedicated visiting space available at the facility to residents who wished to meet with visitors in private.
At St Joseph's Community Hospital in Stranorlar, Donegal, residents did not have adequate space to store their clothes because the wardrobes were small.
As a result, their clothes were stored in an adjacent building where the laundry was carried out.
In some instances, residents' wardrobes and lockers did not fit beside their bed, therefore, their personal possessions were not easily accessible to them.
In east Cork, Glendonagh Residential Home near the village of Dungourney, which was inspected in August, was found to have ongoing issues with staff shortages, inadequate fire safety procedures and inadequate infection prevention and control.
Inspectors noted that a bottle of hand gel and a spray container with disinfectant were located beside a bottle of soft drink in the kitchenette, posing "high risk" to a resident with dementia inadvertently consuming a toxic substance.
The report also notes that hoist slings were shared between residents in the centre and there was no scheduled regime or documentation of the frequency of cleaning of this equipment which presented a risk of cross infection particularly at this time of higher risk of infection with Covid-19.
Recent staff shortages that had been reported were seen on the day of inspection, according to HIQA.
The clinical nurse manager's post was vacant, as well as the post of activity coordinator.
The governance manager had been absent from the centre, working remotely, in recent months.
A shortage of staff nurses meant that the person in charge was also required to work a 12-hour day as a nurse.
According to HIQA, this had a significant impact on her availability to manage the centre, particularly when there was only one other nurse on duty with her.
The report also notes as "significant" only one staff nurse being on duty to care for 42 residents at night.
While it acknowledges support from three health care assistants, there was a dementia unit and an upstairs area to be supervised by night, within "the diverse layout" of the centre.
"Inspectors were not assured that the night-time staffing levels were sufficient to provide adequate supervision and safe care," it said.