HIQA says Waterford residential home needs to improve its management and oversight systems

The Holy Ghost Residential Home on the Cork Road in Waterford, is situated in close proximity to the city centre and to public transport networks. The care provider is the Holy Ghost Hospital Board of Trustees.

An unannounced inspection took place on July 4-5, 2024, and the HIQA report was published on Tuesday, November 5 last. The Holy Ghost Residential Home is a single-storey purpose built centre that includes various renovations and extensions which have taken place over the years to enhance the living spaces for residents.

It contains 60 single bedrooms with full en-suite bathrooms. On the day of inspection, there were 58 residents present. The site is a residential setting catering for residents to live independently with supportive care, and the emphasis is on home-style living where each resident has their own room and living space.

The Holy Ghost residential home does not provide 24-hour nursing care but a registered general nurse is responsible and accountable for the daily running of the home, states the report.

"The supportive independent care model is reflected in the staffing structure which is household, catering and caring staff as in the community setting." Overall, the "consistent and enthusiastic feedback from all residents who spoke with the inspector was that they greatly liked living in Holy Ghost Residential Home.

"The residents described the centre as a 'home from home' and informed the inspector, 'it's lovely here'. Residents were highly complimentary of the staff and the care they received. One resident told the inspector that when it came to the staff, 'you could have a laugh with them', while other residents described the staff as 'the best' and outlined how kindly they were treated.

"The feedback captured the person-centred approach to supported living seen in the centre. Staff were knowledgeable about the residents' needs, and it was clear that staff and management were striving to provide the best care and promote residents' independence in their day to-day lives.

"The inspector observed warm, kind, dignified and respectful interactions with residents and visitors throughout the day by staff and management."

Residents personalised their bedrooms with photographs, artwork, lamps, soft furnishings, religious items, and ornaments. The size and layout of the bedroom accommodation were appropriate for resident needs.

"There was a relaxed and unhurried atmosphere in the centre, and staff were seen responding to resident requests promptly and respectfully. Residents had access to local and national newspapers, radios, and television. Residents could receive visitors in communal areas or in the privacy of their bedrooms."

However, "notwithstanding the good care and support that residents were receiving in their daily lives, the inspector found that more robust management and oversight systems were required to ensure that the service provided to residents was safe, appropriate, consistent, and effectively monitored," stated the report.

The home was found to be compliant or substantially compliant in ten categories of care, and non-compliant in four areas.

These four areas included training and staff development, governance and management, notification of incidents, and the individual assessment and care plans. "There was insufficient managerial oversight of staff practices concerning medication administration and management," found the report.

"A review of the records related to incidents in the centre showed that three incidents in which residents required immediate hospital admission for injury assessment after a fall in the centre had not been notified to the Office of the Chief Inspector of Social Services within the required time frames."

Also, action was required concerning individual assessments and care plans to ensure that each resident's needs were "comprehensively assessed and an appropriate care plan was prepared to meet these needs."