HIQA: ‘Significant effort and resources’ needed at Donegal Community Hospital

The latest Health Information and Quality Authority (Hiqa) report from Donegal Community Hospital highlights a need for significant resources to be made available at the HSE-owned facility.

Donegal Community Hospital consists of a 29-bed unit located on the ground floor, providing palliative care, respite care, convalescence, rehabilitation and continuing care. There are two sitting rooms, a dining room and an oratory for communal use. The designated centre includes a treatment room, staff facilities, a small laundry and a main kitchen.

READ NEXT: Donegal pedals for health and sustainability with Lunchtime Wheelers

An unannounced inspection took place on Thursday, September 19, 2024, with the report published on May 22. On the day of the inspection, there were 21 patients present.

It was acknowledged by inspectors and patients that staff were doing their best to provide a good level of nursing care. However, major improvements were needed by the service providers.

It was noted in the report: “In spite of the best efforts of the staff team working in the designated centre, the poor living environment and facilities provided meant that residents were not supported to have a good quality of life.

“Staff members were observed to have respectful and empathetic interactions with the residents, and it was evident that the staff knew the residents well and were familiar with their needs and preferences. 

“This was reflected in the high levels of satisfaction with the care team that residents reported on the day.”

However, inspectors found that residents were living in an environment that did not promote

their dignity, rights and independence and that did not protect them from the risk of infection. 

“Significant effort and resources are now required to ensure that the current and future residents living in the centre are afforded a safe and comfortable living environment that promotes their independence and meets their needs,” said the inspector.

The report outlined that residents told the inspectors that the staff were kind and respectful, that the food was nice, and that the environment was better than in a hospital.

However, the report also included residents' concerns about toilets, small bedroom space, not enough activities, not enough televisions, and disappointment that the coffee dock is no longer open. 

It was noted that there was a spacious, bright entrance which is also used to access a number of community health and social care services located on the same campus.

But the inspector added: “The bright, spacious and modern entrance is in stark contrast to the living areas provided for the residents living in the designated centre.”

Previous reports raised the need for extensive fire safety works, and it was acknowledged that they are ongoing. Inspectors however described the premises as cluttered, visibly dirty, and in need of extensive refurbishment. 

“In spite of the ongoing building works in the centre, staff worked hard to ensure residents were supported and that the impact was minimised,” noted the inspector. “The centre remained open to visiting, and visitors were seen coming and going during the inspection."

No residents were using the communal areas on the day of the inspection and were seen to spend their time sitting beside their beds. The communal areas included a small dining room, which was not laid out as a dining room on the day and did not provide suitable dining tables and chairs for the residents. Inspectors were informed that this room was used for activities.

There was a main sitting room, which was comfortably furnished but in need of refurbishment and two small sitting rooms, one of which was adjacent to the end of life unit and was used for families of residents in receipt of end of life care. 

There was also a large coffee dock and an oratory. 

“Neither of these communal rooms were available for residents,” reported the inspector. 

“The coffee dock was being used to store a range of furniture and equipment on the day of the inspection.

“The oratory was cold on the day of the inspection and a pane of glass between the oratory and the staff dining room both of which were adjacent to the kitchen was broken with no plan to have this repaired.”

A locked door between the community X-ray department and the care facility prevented residents from being able to freely access the oratory, the coffee dock and the courtyard garden, which were located on the other side of the X-ray department. 

It was noted that in residents' accommodation, some rooms did not ensure that residents could carry out personal activities in private. Furthermore, residents had limited space to store their personal belongings and clothes. 

There were shared en suite toilets and showers between each of the four bedded rooms. The toilets

were cubicle style with limited privacy as the areas above and below the toilet doors were open to the rest of the bathroom, which did not provide adequate protection from noise and odours. 

The en suite facilities were in urgent need of repair and refurbishment and did not afford the residents a comfortable and dignified space to carry out their toileting and bathing activities, it was noted.

It was also reported that there was limited outside space available for residents to use. 

According to the report: “The outside space afforded to the residents consisted of a small enclosed courtyard, which although nicely laid out with seating and colourful plants, residents could not freely access this space because of the locked door between their accommodation and the X-ray department.”

The inspectors observed that the equipment storage had not improved since the previous inspection and equipment, such as wheelchairs, mattresses and unused hoists were stored along some sections of the centre's corridors and in the resident's coffee dock.

During the walk around, the inspectors observed that some residents' records, which contained resident personal information, were located in the corridors and accessible to staff, visitors and workmen in the area. 

It was noted: “This did not ensure that residents' personal information was stored securely and was brought to the attention of the person in charge on the day of inspection.”

Donegal Community Hospital was deemed to be not compliant with regulations relating to governance and management; personal possessions; premises; infection control; fire precautions; and residents’ rights.

It was found to be substantially compliant with regulations pertaining to visits.

Follow Donegallive.ie for coverage of news, sport and events across Donegal.