A HIQA inspection of a private nursing home in June found it was not compliant in 11 out of 17 regulations under the Health Act.
Inspectors raised a number of concerns regarding residents' consent in the home such as staff not getting consent from residents about showering.
Rather than being offered showers daily – as was stated in their care plans - residents were allocated days to shower.
There were 119 residents at the facility on the day that the unannounced inspection took place.
They told the HIQA inspectors that they were put to bed without being asked or being offered consent.
A resident had experienced staff repeatedly asking if they wanted to wear incontinence pads despite not being incontinent.
Inspectors also observed "task-orientated care" during mealtimes.
Staff placed clothing protectors on residents without asking them if they consented to wear the protector first.
The residents were also put sitting in rows of seats that were arranged so that they sat with their backs to other residents.
Inspectors noted that most sat silently while others slept.
When inspectors asked why all the residents were sitting facing the television when it was turned off, staff responded by turning the television on and leaving it on a channel displaying cartoon programmes.
This "was not appropriate activation for residents", according to the report.
Residents spoke to inspectors about how they liked the staff, describing them as ''lovely''. Kind interactions were observed.
However, the report noted that due to staff shortages, residents were required to wait for care.
One resident told inspectors it sometimes resulted in a wait time of up to 30 minutes to attend the bathroom.
As well as insufficient staffing levels HIQA noted that oversight of safeguarding "required improvement".
During the inspection, inspectors "became aware" of a safeguarding allegation which had not been recognised as a safeguarding concern.
They identified three safeguarding concerns that had not been notified to the chief inspector.
Overall, they were not assured that the systems in place overseeing the quality and safety aspects ensured that all residents living in the centre were protected by safe practices which promoted a good quality of life.
They found that safeguarding care plans to direct staff were inadequate and noted that the registered provider acted as a pension agent for ten residents at the time of the inspection.
In response to the findings, the provider said there were policies and procedures in place for "the management of dignity and respect of our residents".
It said "informal education" was being delivered on dignity and respect and person-centred care to all staff.
Training was due to be completed by all staff by last month.
The provider also confirmed that three "notifiable safeguarding incidents" had been reported to the relevant safeguarding team and SAGE advocacy and were retrospectively reported to HIQA on the 20 June 2023.
The report is one of 50 published by HIQA this morning.
At another Nursing Home in Galway, it found noncompliance in relation to the management of residents’ finances, when inspectors conducted an unannounced inspection in May.
One reason for the inspection was to follow up on concerns received by HIQA’s Chief Inspector over the management of resident finances.
HIQA inspectors found serious non-compliance with the overall management of resident finances.
The inspection found that resident pension arrangements put in place by the provider were not in line with national guidance and did not meet their legal requirements.
It said the system in place to return monies to the estates of residents who had passed away was "not robust".
It found that the provider had not identified safeguarding concerns relating to the use of the resident monies that had remained in the company's current account.
An urgent compliance plan request was issued to the provider during the inspection to provide assurance to the Chief Inspector that it was adequately resourced to provide a safe and effective service to residents.
However, the inspectors said the provider "failed to provide adequate assurances".
In response to the report, the provider said resident pension and deceased funds arrangements had been updated in line with National Guidance.
"Residents’ funds will not be used for any other purpose than the resident’s own use", it said.
It added that the residents’ remaining balance, less their weekly personal contribution, would be "safe guarded in a recently opened separate client resident account" and balances monitored frequently by the Accounts Department.
It said all deceased residents’ monies had been returned to the residents’ estate.
At a nursing home in Co Offaly, HIQA found the supervision and allocation of staff was inadequate.
While residents were complimentary in their feedback about the staff, who they described as "very helpful" they expressed concern that staff were "always rushing" which resulted in long delays waiting for assistance.
Inspectors observed that a number of residents did not have their call bell within reach from their beds, or when sitting out on a chair in their bedroom.
A resident told inspectors that they were nervous about standing up from their chair on their own as they felt unsteady on their feet but could not reach their call bell to call for help.
On three occasions during the inspection, inspectors were required to locate staff on behalf of residents who required assistance.
Visitors voiced their dissatisfaction about the visiting restrictions and described their experience as "sometimes unpleasant".
They described how they had to leave the centre at a specific time, and if staff were delayed answering the doorbell, this shortened their visiting time with their relatives.
Inspectors observed that visitors were queuing to access and exit the centre during the allocated visiting times.
HIQA found that a weak organisational structure, failings in the governance and oversight including risk management systems, and inadequate staffing resources significantly impacted on the quality and safety of the care provided to the residents living in the centre.
The unannounced inspection took place in June, following one in January, when the provider committed to taking action to improve the service.
However, the latter inspection revealed that the Chief Inspector had not been notified of the unexplained absence of a resident from the designated centre, or of a serious injury sustained by a resident.
Inspectors found that actions to protect residents who required close supervision were not in place.
A review of the rosters found inadequate staff levels available to meet the health and social care needs of the residents, and to ensure that they received safe and effective care.
"Recorded incidents were poorly detailed, and all the possible contributing factors had not been identified or considered.", according to the report.
The provider said it recruited three nurses who commenced their work in July, and a further three nurses were expected to begin at the facility this Autumn.
It said any deficits with rosters would be supported by agency shifts when required.
Training was also provided to staff on responsive behaviours, incident management and record keeping in July according to the provider.
It said further training had already been arranged.
