Positive HIQA report for Harbour Lights but concerns over use of restraints

An unannounced inspection by the Health Information and Quality Authority (HIQA) found significant improvements at Harbour Lights Nursing Home.

The centre overlooking Killybegs Harbour provides 24-hour care for 45 male and female adult residents with a range of care needs including dementia. 

The inspection took place on February 24 with the report released on August 3. The facility was found to be compliant or substantially compliant in all areas of patient care, governance and safety.

However, concern was raised over the use of restraints.

According to the HIQA inspector: “Overall, the general care and support given to residents in the centre was of a high standard and had significantly improved since the last inspection.

“Residents in the centre were safe from potential harm, and in general, residents' independence, health and well-being were being promoted. 

“Members of staff observed by the inspector were kind and supportive to residents during the inspection, and residents who spoke with the inspector said they liked living in the centre.”

Regarding the use of restraints to prevent falls for three residents, the inspector noted that this was not in line with the regulatory requirements and national guidance. 

The inspector reported: “For example, a review of care records showed that alternatives such as enhanced supervision of residents by staff had not been trialled before lap belts had been used for these residents. 

“A restraint release log regarding the use and release of a lap belt had not been maintained to ensure that they were used for the shortest period of time. The use of a lap belt for one resident had not been recorded in the centre's risk register. 

“In addition, the inspector observed that a lap belt was used for a resident who had not been assessed for using a lap belt.”

Other areas for improvement included a patient being in a room with no window, and inadequate privacy curtain in a twin room. 

It was also noted that further actions were required to bring the centre to full fire safety compliance. For example a fire door on the laundry was being wedged open with no mechanism to automatically close if a fire alarm sounded. However, overall the fire safety precautions and evacuation plans were found to be satisfactory. 

Another area highlighted for improvement was the insufficient provision of meaningful activities and social interactions for some residents. 

According to the inspection report: “This was leading to poor outcomes for these residents, who spent most of their day with little to provide them with appropriate stimulation and engagement.”

Harbour Lights Nursing Home was found to be compliant in areas of training and staff development, premises, fire precautions, individual assessment and care plan, managing behaviour that is challenging, and residents’ rights.

It was deemed fully compliant in staffing, directory of residents, records, insurance, governance and management, statement of purpose, notification of incidents, complaints procedure, written policies and procedures, personal possessions, temporary absence or discharge of residents, risk management, health care and protection.

The full report can be found at HIQA.ie

A plan of action has been put in place to bring the facility to full compliance.