Kilkenny nursing home records alarming compliance drop in new HIQA report

Tinnypark Nursing Home was rated as non-compliant in 10 out of 16 areas and compliant in just one in a new Health Information and Quality Authority (HIQA) report released on Thursday.

The results are a startling turnaround from the nursing home’s performance last year, when it was compliant in 10 areas without receiving a single non-compliance.

The inspections took place on January 20-21 and although residents were generally satisfied with the care provided and inspectors observed staff treating them with dignity and compassion, multiple serious issues were noted across areas such as facilities, staffing and safety.

Despite staff having access to a suite of training programmes, 20 hadn’t been trained in managing challenging behaviour, 14 hadn’t had fire safety education in 2024, while two lacked training in safeguarding adults at risk of abuse.

When entering the premises, inspectors observed that the nurses station was located adjacent to the door with the computer screen visible and displaying resident’s private information, an issue that was seen to persist for the duration of the inspection.

In addition, records relating to deceased and discharged residents were stored in the centre’s boardroom which was unlocked.

Staff acquisition and retention was also a recurring problem. The Assistant Director of Nursing position had recently become vacant and the Clinical Nurse Manager role which had been open on the previous inspection in June 2024 had still not been filled despite recruitment efforts.

Turnover was high with just under 40% of staff working in the centre for less than six months, something which had a significant impact on the continuity of care.

Housekeeping staffing wasn’t in line with the centre’s statement of purpose as there was a requirement for two housekeepers and a laundry assistant to be on duty, however there were none of these present on the first inspection day.

Issues with premises included three out of the six washing machines being out of order with two of them containing residents’ laundry. 

Sixteen bags were waiting on laundering and the volume of this led to the area being highly disorganised with clothing on the floor while in bedrooms some call bells were not within reach of residents beds, meaning they could not summon assistance if required.

In the kitchen, inspectors were not assured that food was properly and safely prepared for cooking and serving with the environment, equipment and utensils observed to be unclean.

Some appliances, such as the microwave, were damaged. Food was not stored safely in line with best practice and nutritional supplements were not stored securely.

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Cleanliness was also a problem in other areas as it was found that the communal toilet, storage, and staff and ancillary support areas were visibly unclean.

No schedules were available to ascertain the frequency of routine and deep cleaning of resident bedrooms, en-suites or equipment while a number of rooms were found to have large pieces of dirt and debris under the beds.

There were several risks which could cause a fire or hamper evacuation in the event of one such as four of the emergency exits being obstructed, the lack of a call bell in the smoking area to summon help in the event of a fire and 12 oxygen cylinders which were found unsecured in an unlocked, open nursing office.

On their review of individual assessment and care plans, inspectors looked at a sample of four records and found significant issues in all four, including a resident assessed to be at medium risk of malnutrition who didn’t have a nutrition care plan and another with a skin condition who didn’t have a skincare plan.

Some of the areas of non-compliance were addressed immediately such as the centre taking action in sourcing an external laundry company and cleaning agency to improve the laundry and kitchen cleanliness situation.

Solutions to the staffing problems have also progressed after both a Clinical Nurse Manager and Assistant Director of Nursing were appointed. 

All areas of concern were required to be addressed by the end of June at the latest with the nursing home outlining how this would be achieved in detail on their compliance plan.

Tinnypark did not return requests for comment.

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