Trauma and health risks to Avondale residents

RESIDENTS at Avondale Nursing Home were place under unnecessary trauma, upset, medical and mental health risks when the director started to discharge them over a 48-hour period in late July.

RESIDENTS at Avondale Nursing Home were place under unnecessary trauma, upset, medical and mental health risks when the director started to discharge them over a 48-hour period in late July.

Two residents, one of whom is terminally ill and another who is receiving palliative care were to be transported to a nursing home in a wheelchair taxi, which was totally unsuitable and would have placed these residents at serious risk. One of these residents cannot communicate for herself and the records provided no evidence that her family had been informed or consulted.

Another two residents were wards of court and no evidence was found that the office of the ward had been informed of the discharge of one of these wards. Another two residents were admitted to the nursing home under the care of the community mental health team and the report stated that the move ‘in such an unplanned manner could present a seriosu risk to their mental well being.’

The damming report by the Health Information and Quality Authority (HIQA) stated that the actions took no account of the contracts of care agreed or the provider’s duty of care. Inspectors also found that Ms Miriam Holmes gave inaccurate information to residents, suggesting that this was a temporary move rather than a long-term arrangement. In taking this action the Ms Miriam Holmes had committed serious breaches of a number of regulations including: Temporary Absence and Discharge of Residents, General Welfare and Protection, Residents’ Rights, Dignity and Consultation, Health Care, Assessment and Care Plan, Medical Records and Food and Nutrition.

Ms Holmes met with inspectors and confirmed that some residents, 12, were being moved as she wished to undertake building and fire safety works. She had incorrectly informed staff, residents and relatives that the Authority had insisted that she undertake this work urgently. She informed inspectors that some residents, six to eight, were to remain and that the centre would stay open in a limited capacity. According to the report, published today (Wednesday) Ms Holmes declined to engage in any constructive or informative way with inspectors, informing them that the plan was ‘in her head’.

Ms Holmes refused to engage with the inspectors constructively on July 20 and informed them that she would meet with them on July 22 and refused to give clear information. She requested that her daughter, Hayley who is the key senior manager attend a meeting between inspectors and the person in charge of another nursing home so as not to allow the inspectors to obstruct the process of discharging the residents.

At this stage HIQA contacted the HSE who came to the nursing home on July 21 to ascertain the safety and welfare of residents. HIQA went to Avondale on July 21 and instructed Ms Holmes to stop discharging residents and to voluntarily agree that the HSE would oversee the orderly and safe discharge of residents and the closure of the centre. Ms Miriam Holmes indicated that she would do so but insisted that the centre would remain open. Inspectors arranged for a senior member of HIQA staff to meet with her that afternoon to finalise arrangements and to sign the necessary papers. Ms Holmes left the centre at 11.30am and did not return and could not be contacted by the Authority.

The report also stated that a number of residents were told that they had to move, without the support or advice of their families which they confirmed was additionally traumatic. They were given no opportunity to adequately make an informed choice as to where they would move to. Residents GP’s had not been informed or consulted and no adequate arrangements were made for continuity of medical care.

One relative was not informed until visting on July 20 that her relative was already moving to another already identified nursing home on July 21. This placement was completely unsuitable for theis reisdent as it would effectively have prevented the maintenance of family contact and engagement.

The report also stated that Ms Holmes was unable to provide evidence that residents’ personal property, possesions, statement of accounts, monies held or state pension books had been returned and accounted for to residents or their relatives.

Staff also informed inspectors that salaries which were due to be paid on July 20 had not been lodged to their bank accounts. On July 21 the HSE agreed to take responsibility for the salaries in the interim period, while they oversaw the orderly and safe discharge and placement of residents. Stocks of food were also very limited and the HSE were obliged to buy basic essentials such as meat, bread and milk.

For further reports on Avondale Nursing Home see next week’s edition of the Kilkenny People