The Health Information and Quality Authority (HIQA) has published 47 inspection reports on nursing homes and residential centres for older people.
Six centres were not compliant with four or more regulations under which they were inspected; including residents' rights, protection, staff training, and development.
At a Wexford nursing home, an inspector discovered gaps in weight monitoring records for a resident at risk of malnutrition who was required to be weighed monthly.
One of the gaps was 20 weeks long.
The inspector found that care plans covering key assessed needs, including falls and mobility, nutrition, elimination, cognition, pain management and end-of-life care, had not been updated at four monthly intervals as required.
A resident who fell and sustained several injuries did not have their falls care plan updated in the previous six-and-a-half months before their fall, despite the resident being noted as weak due to illness before their fall.
By not updating care plans at required intervals, HIQA described it as "a missed opportunity" to identify potential risk factors.
Of three residents' records seen by the inspector in the home, there was no evidence of consultation with the resident and, where appropriate, their family when care plans were reviewed.
A Dublin nursing home was directed to ensure assessments and care plans be reviewed and updated when there's a change to a resident's condition.
The inspection report cites a resident who had a pressure ulcer.
While their care plan had been updated, this did not incorporate the changing needs of the resident.
The resident was due to be repositioned every two hours, however, there was no record available of this occurring. Another resident with a pressure ulcer had their assessment completed, however, the information in it was incorrect.
HIQA said this meant that the care plan did not meet their needs.
At a community nursing unit in Limerick, a resident's care plan was not updated to reflect the changes in their condition on return from hospital.
Furthermore, two care plans did not reflect a residents skin condition or the presence and management of pressure ulcers and another regarding a skin tear, so that staff were aware of the wound care management plan.
HIQA inspectors pointed out that these could lead to omissions or errors in care delivery.
In a Co Waterford care centre, inspectors were not assured that the registered provider had taken all reasonable measures to protect residents from abuse.
Some residents with a history of behaviours, which were a known safeguarding risk to other residents, had measures documented to mitigate the risk.
However, these measures had not always been effective and failed to protect residents from abuse according to the report.
This finding was evidenced by the "continuance of physical and verbal peer-to-peer abuse incidents by a number of residents in the centre", according to the report.
While staff had completed online safeguarding training, which was supplemented with face-to-face in-house training at a later date, inspectors were not assured that all the staff had the required knowledge, experience and skills to prevent instances of abuse and protect vulnerable residents from harm.
At a Co Kerry community nursing unit, HIQA was not assured that complaints were investigated appropriately.
Two complaints did not have records maintained of the outcome of the investigation.
There was no evidence that written responses were provided to inform the complainant whether the complaint was upheld, or of any improvements or learning arising from the complaints.
HIQA has pointed out that this is "a regulatory requirement".
The inspections, resulting in the 47 reports, were carried out between October last year and April this year, prior to the RTÉ Investigates programme that focused on two Emeis Ireland run nursing homes in Dublin and Portlaoise.
There are no nursing homes belonging to the Emeis Ireland contained in the reports published today.
All providers inspected by HIQA are given an opportunity to explain how they would respond to non-compliance. The responses are contained in the reports which have been published on HIQA’s website.
Of the 47 reports published, inspectors found evidence of good practice and compliance with the regulations and standards in a number of inspections.
