Fire safety concerns at Carndonagh Hospital include cable-tied gas valve

An inspection by the Health Information and Quality Authority (HIQA) found Carndonagh Community Hospital to be Not Compliant in areas of fire safety and governance.

This included a gas valve being cable tied, meaning the gas could not be shut off in the event of a fire.

However, the inspector found that patients on the whole were happy, and findings of Compliance were recorded in most elements of the inspection.

The unannounced inspection of the HSE-run facility took place on October 20 and was published on February 23. 

Carndonagh Community Hospital is a designated centre registered to provide health and social care to 46 male and female residents primarily over the age of 65 who live in the Inishowen area.

The single-storey building consists of three units, Oak and Elm wards providing general and

respite care and Ard Aoibhinn a dementia specific unit. There are several communal seating and dining areas where residents can spend time during the day around a central courtyard. 

A day care service that is separate from the residential area is provided on-site.

On the day of the inspection, there were 26 residents present. 

Good Quality of Life

The inspector reported: “Overall, the residents enjoyed a good quality of life in the designated centre. The residents' choices were respected in the centre, and resident-focused care was delivered in this designated centre.”

Inspectors spoke to several residents during the inspection, and many commented that they were happy in their homes. They also reported that they were happy with the staff and with the service that they received. 

In the Oak Unit, bedroom and bathroom facilities were good overall. Many residents told the inspectors that they loved their bedrooms.

However, the oak unit was found to have insufficient call bells available in some communal toilets, especially near the toilet and shower areas, to support residents if they needed to call for staff assistance.

It was also found that there were insufficient hand sanitisers available near the sluice room.

The inspectors noted that privacy curtains in a four bedded room in the newly refurbished unit did not fully extend to ensure the resident's privacy.

Furthermore, several residents in twin-bedded rooms in Ard Aoibhinn unit did not have access to a window. As a result, they did not have access to natural sunlight or see out through the window of the rooms when other residents decided to use their privacy curtains.

It was noted that the Ard Aoibhinn unit and chapel area required repainting. 

The floor linings and door frames of bedrooms and some communal rooms in Ard Aoibhinn unit were visibly damaged and needed to be redecorated.

Fire Safety 

This was an area of particular concern.

A safety gas valve located outside the chapel area was found to be cable tied. 

The inspector said: “This arrangement did not allow to shut off the gas supply during a fire Emergency.”

The inspectors observed storage of electrical equipment and flammable items stored in a switch room (used to manage electrical systems in the centre).

According to the inspector: “This presented a potential fire risk - if a fire did develop, it would be accelerated by the presence of these items.”

In the chapel area,  wax candles and fire lighters were used, and combustible items were stored near a gas boiler located in a room near the chapel. 

The inspector noted that even though the centre had a risk management system, it failed to identify and manage the fire safety risks in the centre. 

“The provider needs to improve the means of escape for residents and emergency lighting in the event of an emergency in the centre,” the inspector reported.

“There was a lack of emergency exit signage in some areas to indicate the route to access a fire exit.”

Emergency lighting outside a final fire exit door was not functioning on the day of the inspection. Directional signage was unavailable outside a final fire exit door in order for residents and staff to be aware of the location of the fire assembly points.

“Some fire exits were not readily openable and required a key to unlock them,” the inspector reported.

“In addition to this, a gate located in an external enclosed garden area was found to be fitted with a padlock, and required a key to unlock it.”

A number of fire doors observed by the inspector had door-closer mechanisms and fire door seals missing. Gaps were noted at the bottom and between doors. Furthermore, a number of fire doors did not meet the criteria of a fire door and did not close fully when released.

Other fire safety concerns noted included discrepancies in floor plans, storage of combustible materials, fire doors not fully closing, a lack of fire action notices, and the need for comprehensive fire drills.

The provider was issued with an urgent action to manage the fire safety risks in the centre.

Activities

In terms of activities, staff were found to be knowledgeable of residents’ need.

According to the inspector: “The residents in the designated centre were found to be engaged in a range of social care activities.

“Several residents who spoke with the inspectors said that they enjoyed the activities in the centre. Some residents were found to be engaged in playing puzzles in the dementia-specific units, and the staff were found to be encouraging residents with verbal clues to complete the puzzle, and the staff were found to be supportive of the residents' needs.

“Some residents told the inspectors that they enjoyed gardening and that

they felt like being at home and safe in the centre.”

Care Practices

With regard to care practices, inspectors found that the staff assisted with the needs of the residents. Call bells were attended to in a timely manner. 

Residents reported that the staff attended to their needs in a kind and respectful manner. 

Overall the care provided to the residents was of good quality, and the clinical oversight of the centre had significantly improved since the last inspection. 

The inspector reported: “The provider had made arrangements to renovate the Oak unit, however, the oversight required for maintaining the physical environment of the centre required significant improvements to ensure that the residents are safe in the designated centre.”

Meals

Menu choices were available and inspectors noted that the residents were provided with meals that were wholesome and nutritious. 

The meals were not hurried, and mealtimes were a relaxed social occasion for the residents. 

Compliance Findings

Carndonagh Community Hospital was found to be complaint in areas of Staffing; Training and Staff Development; Records; Complaints Procedure; Personal Possessions; Quality and Safety; Risk Management; Individual Assessment and Care Plan; Health Clare; Managing Behaviour that is Challenging; Protection; Residents’ Rights; 

It was found to be Substantially Compliant in Notification of Incidents; Infection Control; Medicines and Pharmaceutical Services; 

The centre was deemed Not Compliant with regard to Governance and Management; Premises; Fire Precautions; 

Measures have since been put in place to address areas found to be Not Compliant or Substantially Compliant.