Non compliance in fire safety and safeguarding at Aras Gaoth Dobhair - HIQA

A recent unannounced Health Information and Quality Authority (HIQA) at Aras Dobhair found non-compliance in nine of the 18 regulations inspected. 

Aras Gaoth Dobhair is a purpose-built centre in Gaoth Dobhair that provides convalescent and respite care to male and female residents primarily over 65 years with low-to-maximum dependency needs. It has a dementia unit which can accommodate 20 residents and a separate general unit for a further 21 residents. 

The inspection took place over two days on April 19 and 20 and the report was published on August 3. It was found that improvements which had previously been achieved and not been sustained. 

According to HIQA: “Significant shortcomings were found in areas of fire safety, safeguarding, and managing responsive behaviour. 

“Furthermore, the culture of the organisation did not promote the dignity, rights and autonomy of all of the residents and ensure that residents were appropriately consulted in matters relating to their care and daily lives in the designated centre.”

Fire Safety

Regarding fire safety, inspectors found that the precautions in place in the centre did not protect residents in the event of a fire emergency.

According to HIQA: “The inspectors identified significant non-compliance and fire safety risks on this inspection. In addition, the provider had failed to come into compliance with their own compliance plan from the previous inspection held in 2022 in relation to fire safety. 

“At the end of the inspection the provider was issued with an urgent compliance plan requiring them to submit an action plan setting out how they would bring the designated centre into compliance.”

This plan was duly submitted.

Care

Inspectors found that residents’ needs were being assessed comprehensively. However, some additional improvements were required to ensure that the residents' care plans contained information about managing high-risk medicines, such as insulin.

And while residents had access to GP care and specialist practitioners, additional improvements were required to ensure that residents were referred to allied health professionals in a timely manner. It was also noted that improvement was needed in implementation where specialist practitioners had prescribed a course of treatment.

Other areas of concern noted during the inspection included inadequate protection for resident's personal money.

And while corridors were wide and had handrails, storage of portable hoists along some corridors blocked the handrails and created a risk for residents. 

Activities

Both units had spacious communal units but it was felt their use was not being maximised. Inspectors observed that residents on both units spent most of their time watching television or sitting quietly in the communal areas.

According to the inspection report: “This inspection found that residents did not have sufficient opportunities and facilities to participate in meaningful activities in accordance with their interests, abilities and capacities.

“Inspectors found that key activities such as resident meetings and religious services had not resumed in the centre since the start of the covid-19 pandemic.This was an unacceptable delay and did not uphold the residents' religious rights and the rights of the residents to be consulted in the planning and delivery of services.“

It was noted that recruitment for two staff to provide a programme of activities was underway. 

Outside, inspectors found that the garden was poorly maintained with uneven surfaces posing a trip hazard. The garden gates at the perimeter of this area had been removed, and as such, the garden was not secured for residents to use.

Access to an enclosed courtyard garden on the dementia specific unit was locked throughout the second day of the inspection. 

The inspector reported: “The garden had been renovated and landscaped in 2022 as a dementia friendly space for residents to access without risk, however residents were not permitted to access this safe outdoor space unless there was a member of staff available to accompany them. When this was brought to the attention of the provider, they informed the inspectors that the internal courtyard door was kept locked to minimise injury risks to residents in the centre.”

Inspectors found that this was an overly restrictive practice and did not promote the autonomy of the residents. 

Positive findings included residents being supported in using Irish as their first language, and residents having access to newspapers, radio and television.

The inspector said: “Residents who spoke with the inspectors said that staff were kind and caring and that they felt lucky to be able to stay in their own community in Gaoth Dobhair.”

The nine areas of non-compliance found by inspectors were staffing, training and staff development, records, governance and management, fire precautions, health care, managing behaviour that is challenging, protection and residents’ rights.
It was deemed substantially compliant in contract for the provision of services, volunteers, premises, infection control, medicines and pharmaceutical services, and individual assessment and care plan. 

Aras Gaoth Dobhair was found to be compliant in persons in charge, statement of purpose and visits. 

The full report can be found here

A comprehensive plan has been put in place to bring Aras Gaoth Dobhair to full compliance.