Happy residents at Harbour Lights but restraint use non compliant, HIQA finds

An unannounced inspection by the Health Information and Quality Authority (HIQA) found that residents at Harbour Lights Nursing Home were largely happy with their care. 

However, there were a number of areas of non-compliance with regulations at the facility owned by Caring Hands Limited and located Townasligo, Bruckless, overlooking Killybegs harbour. 

The findings of non-compliance noted at the inspection which took place on February 7 and published on May 29 related in particular to the regulations on Managing Behaviour That is Challenging, and Fire Prevention.

According to HIQA: “The inspector was not assured that the staff had sufficient knowledge and skills to manage responsive behaviours. For example, appropriate assessment had not been carried out for three residents to identify and consider the causative and influencing factors for the residents' responsive behaviours. 

“Furthermore, the care records of five residents indicated that appropriate person centred de-escalation techniques, such as non-pharmacological measures, had not been trialled before administering chemical restraints to manage their responsive behaviours. 

“Additionally, lap belts had been administered to these residents during the early morning and night hours to manage responsive behaviours instead of implementing person-centred de-escalation techniques as set out in their care plans.”

It was also noted that the inspector was not assured that the restrictive practices were used in accordance with national policy. 

Regarding fire prevention, the inspector found that there was insufficient fire stopping in the laundry room, which is a high-risk area for fire. 

The inspector further reported: “There was insufficient fire stopping around the electrical cables that penetrated through the ceiling of a store room.

“The fire doors in the laundry and one store room had holes due to missing key locks or door handles.

“The intumescent strips of the fire door in an office were missing, and several electrical appliances were used in this area. As a result, they were ineffective in containing fire and smoke in a fire emergency.

“There was insufficient fire compartmentation between the boiler room and a linen storage room.

“Furthermore, the provider's arrangements for reviewing fire precautions in the centre were insufficient. For example, a final fire exit door near the dining room was blocked due to cars being parked outside this fire exit door.”

The inspector also found that some staff did not demonstrate sufficient knowledge of fire procedures and evacuation plan.  

There were 55 residents present at Harbour Lights on the day of the inspection. The facility is registered to  provide 24 hour care for 56 male and female residents over the age of 18 who have a range of care needs including dementia. 

The inspector noted: “Overall, the residents' feedback about the care and service provided to them was highly positive. 

“Residents were able to enjoy the panoramic views of the sea from several communal rooms and bedrooms in the centre. Many of the residents were from the local area and enjoyed watching the fishing fleet in the harbour and the comings and goings along the waterfront in the town.”

As well as enjoying the view, residents praised the kindness of staff, the quality of food and the availability of activities and outings. 

The inspector found the premises to be clean, with wide corridors and handrails to support residents’ safe mobility. 

“However, the storage of equipment near the entrance of the communal toilets posed a potential trip hazard for residents using these toilets,” the inspector reported.

Staff were found to respond quickly to the needs of patients, and meals were served in a pleasant and unhurried manner. 

Findings of Compliant were noted in regulations on Communication Difficulties, Visits, Medicines and Pharmaceutical Services, 

Harbour Lights was Substantially Compliant in Staffing, Contract for the Provision of Services, Training and Staff Development, Premises, Infection Control, Individual Assessment and Care Plan, Health Care, Protection, and Residents' rights.

It was deemed Not Compliant in Governance and Management , Notification of Incidents, Complaints Procedure, Fire Precautions, and Managing Behaviour that is Challenging.