'Urgent' action required after Laois nursing home again fails HIQA regulations

A large new Laois private nursing home in Portlaoise has failed to meet five out of ten regulations in its third HIQA inspection, with a concern raised to HIQA that residents could leave the home unnoticed.

The three storey new home called The Residence Portlaoise on Harpurs Lane is built beside the railway line in the busy town centre.

It has failed five regulations by the Health Information and Quality Authority (HIQA) in an unannounced inspection in October 2024, with details just published. It "substantially complied" with three more, but only fully complied with two regulations on the day. It's previous inspection had found that five out of 12 regulations were non-compliant or substantially compliant.

HIQA now say "urgent action is required".

HIQA say their Chief Inspector had received an alert about the "unexplained absence of a resident" and the nutritional value of the food served. 

HIQA said that the inspection was a follow up to see what actions were taken by the provider "following monitoring notifications submitted to the Chief Inspector, pertaining to the unexplained absence of a resident from the designated centre".

They said that the notifications raised "concerns regarding the quality and safety of the care provided to vulnerable residents who were at risk of leaving the centre unnoticed and unaccompanied, and the quality of nutritional care provided to residents. This information was substantiated on this inspection."

The inspection was also done to check how the home had addressed "significant issues of non-compliance found on the last inspection in July 2024 with regard to the governance and oversight of the service".

"The findings of this inspection were that the provider had not fully implemented or sustained their compliance plan following the previous inspection of the centre in July 2024, and urgent action was required with regard to the governance and management of The Residence Portlaoise. Inspectors found that a weak organisational structure, and ineffective management systems of monitoring and oversight impacted on the quality and safety of the care provided to residents.

"Inspectors found that the provider had not effectively managed risks to residents' safety and welfare. Actions to protect residents assessed as requiring close supervision were not fully implemented, and there continued to be inadequate and ineffective risk management systems in place to ensure the safe, and monitored delivery of care to residents.

"Furthermore, inspectors found that the systems in place to ensure effective monitoring of residents' nutritional care needs and nutritional risks were not effective. As a consequence of these concerns, an urgent compliance plan request was issued to the provider following this inspection."

The five regulations that failed are: training and staff development, records, governance and management, individual assessment and care plan, and health care. 

Four of those had also failed a previous HIQA inspection, under healthcare, governance and management, records, and the individual assessment and care plan regulation. The governance and managment failure was given a Red high risk status.

To comply, HIQA say that the nursing home must "ensure that management systems are in place to ensure that the service

provided is safe, appropriate, consistent and effectively monitored".

The home was "substantially compliant" with three more regulations: the complaints procedure, the management of challenging behaviour, and protection. Two of the ten regulations were fully compliant; staffing, and residents' rights.

Despite the failures found, the inspectors reported that residents told them they felt happy and safe.

"Residents stated that they were happy, felt safe, the food was good, and that the staff were kind to them. Inspectors observed warm, kind, dignified and respectful interactions between staff and residents throughout the day of the inspection.

"There was a comfortable and homely atmosphere in the centre. Inspectors observed that the centre was bright, visibly clean, spacious and laid out to meet the needs of the residents".

The 101 room private nursing home opened in late 2023 and it had 55 residents on the day of the inspection.

The business has given a detailed Compliance Plan to HIQA setting out the actions it has taken or is going to take, to become fully compliant with regulations. This includes increased staff, more training, more records and more reviews.