Surgical glove over smoke alarm among fire risks at Laois HSE nursing unit

Inspectors with Ireland's health service watchdog found a surgical glove placed over a fire detector and many other fire risks on a return visit to a HSE community nursing unit in Laois where fire safety shortcomings were flagged earlier this year. 

The 57-bed St Vincent's Community Nursing Unit in Irishtown was found to be non-compliant with a number of fire regulations during the latest unannounced visit on August 23 by the Health and Information and Quality Authority (HIQA).

A HIQA  inspection in February  raised concerns about fire safety and a  HIQA visit in August was primarily focused on fire safety. 

There were 55 residents in the  unit on the date of inspection in August.  HIQA  found that while some fire safety measures had been undertaken, issues remained.

The August Inspection report was published this week by HIQA.

“Inspectors noted that there were a number of issues in the centre that impacted on fire safety. Inspectors observed that gates had been placed at the top of both staircases in the centre. Trollies were stored along escape routes. Both of these issues impacted on the safe evacuation of residents in the event of an emergency,” the report noted. 

“An urgent compliance plan was issued to the provider to remove these obstacles. Inspectors also noted that signage throughout the centre relating to fire safety required improvement. Some signage was out of date and some signs displayed conflicting information,” the report continued. 

“Inspectors observed issues relating to the maintenance of fire doors throughout the centre and that attic hatches were not fire rated. This impacted on the ability to contain smoke and fire within a section of the building in the event of a fire. Inspectors noted that flammable and combustible materials were stored next to each other in overfilled store rooms. This increased the risk of fire,” the report stated. 

“Further, inspectors noted that one fire detection head in a store room had been covered with a surgical glove, which meant that it would not detect smoke in the  event of a fire. At inspectors' request this was removed on the day of inspection,” the report continued. 

“The findings of this inspection were that the provider had failed to take the required action to address significant non-compliances that had been identified on the last Inspection,” the report stated.  

“Given the totality of the findings of this inspection an urgent compliance letter was issued to the provider in the days following the inspection. The registered provider engaged in this process, and supplied the requested information within the specified timeline. This information provided assurance to the chief inspector that the issues raised were being addressed,” it stated.

In response to the report, HSE Management outlined the measures it has taken and plans to implement.  They said “the units Fire Policy/Evacuation Policy is under review” and “storage rooms in all departments have been decluttered, cleaned and tidied with all excessive materials removed.”

“The stair gates at the top of both stairs on the first floor have been removed to ensure there is no impediment on the fire evacuation escape route,” they said. 

Management also put in place daily checks of all fire exits and escape routes  to ensure fire exits are unobstructed and escape routes are clear.

“Following the completion of a fire safety risk assessment, fire safety structural upgrade works are planned to commence onsite. The contract to complete the works outlined in fire risk assessment report has been awarded to a specialist company. Fire safety upgrade works and fire containment works are due to commence on site prior to the end of 2023. These works will also include the replacement of fire doors, fire stopping at wall and ceiling penetrations,” they  said. 

HIIQA  also found the unit wasn’t compliant in terms of governance and management and in relation to capacity and capability inspectors wrote.

“The registered provider of St Vincent's Community Nursing Unit is the Health Service Executive (HSE). The management structure, as set out in the centre's statement of purpose, consisted of a person in charge supported by an assistant director of nursing, eight clinical nurse managers, a clinical facilitator, and a clinical nurse specialist in dementia. 

“This was not in place on the day of inspection. Three positions for nurse managers, clinical nurse facilitator, and assistant director of nursing were vacant or not back-filled. The clinical nurse specialist in dementia was redeployed to carry out nursing administration duties.”

In response, management said:  “The Management structure within the unit consists of an Interim Director of Nursing who is supported in her role by two clinical nurse managers in Nursing Administration. Plans are in place for the Assistant Director of Nursing to return to her substantive post in the next six weeks”.

They also stated that work was underway to fill other vacant positions at the unit.  

The HIQA report noted the impact of  ongoing work at the unit.  

“The systems in place to manage risk were not effective. Inspectors noted that the impact of the ongoing construction works had not been adequately assessed. The provider had not assessed the impact of noise on residents and ensured that adequate measures were in place to limit the impact on residents,” the report said.

There was an outbreak of Covid with six confirmed cases correctly isolated at the time of  inspection.