Trim nursing unit manager 'failed to investigate abuse complaints properly'

The failure of a Health Service Executive (HSE) manager to properly investigate allegations of abuse of residents at St Joseph's Community Nursing Unit in Trim has been met with a reaction of disappointment and concern by local public representatives and an organisation catering for the welfare of the elderly this week. An independent investigation by the Health Information and Quality Authority (HIQA) found that there were "serious shortcomings" in the way the allegations concerning incidents at the unit, formerly known as St Joseph's Hospital, were dealt with. HIQA was not notified of the issue within a timeframe set down by regulations. The HSE said this was the first such inspection of the unit and, while the findings in the report were "challenging", they presened a significant opportunity for learning. A detailed action plan had now been developed in response to the findings and many actions had already been implemented or were in the process of being implemented in the immediate future, it said. The management wanted to assure people that any allegations which might arise in the future would be managed in a "thorough and robust manner" and in accordance with HSE policies and legislative requirements. Fianna Fail Cllr Jimmy Fegan said that he would first want to put on record the institution's staff's "unenviable record" over many decades in caring for the comfort and welfare of senior citizens. However, he said he found it concerning that an allegation of abuse by a staff nurse against patients did not appear to have been dealt with in the proper fashion. Sinn Fein Cllr Joe Reilly, a member of the Dublin North-East Regional Health Forum, welcomed the findings by HIQA and said that the report clearly identified policy failures which would have to be addressed immediately. The Age Action organisation also expressed serious concern at the findings. "Nursing home residents are among the most vulnerable people in our community and they depend on all allegations of elder abuse being promtly and correctly investigated," spokesman Eamon Timmins said. "The HIQA report is a cause of serious concern and undermines so much good work being done by staff at the unit and in other nursing home centres around Ireland." The organisation appointed a part-time advocacy officer to St Joseph's in Trim last November. The alleged abuse occurred prior to that appointment. Age Action said it was unaware of the allegations prior to Monday of this week. HIQA was scheduled to inspect the 147-resident home on 23rd September but, a week beforehand, it was notified of allegations of abuse of residents. Its report said that the person in charge of the home did not investigate the allegations in a timely manner in accordance with HSE policy, nor had relatives been informed. No immediate protection measures for residents were introduced, the report added. Independent inspections of nursing homes began on 1st July last. The inspection reports are meant to provide information to the residentas themselves, their families and the general public about the standards of care in individual centres. The organisation said that a subsequent action plan prepared by the home to deal with the protection of residents from abuse was "unsatisfactory", as the nurse at the centre of the abuse allegations remained on duty. The nurse was put on administrative leave on 5th November last, following two incidents of alleged abuse, which HIQA said it was not notified about, despite requirements under nursing home regulations. HIQA itself has made a complaint to An Bord Altranais about the fitness to practice of the nurse. The management of the home submitted a written response to the inspection, stating that the concern raised in relation to the supervision of the staff member and notification of residents during the investigation had been rectified. A new policy adopted in November now ensured all complaints were recorded and addressed. HIQA inspectors also found that there was poor leadership and management in the nursing home, which directly impacted on the care of residents. They said that management of general complaints was unsatisfactory, with no supporting documentation to prove that some investigations had taken place. There was also lack of management supervison at night and an over-reliance on agency staff at the home. The working patterns and rostering of staff did not always ensure continuity of care or maximise safety and staff levels did not always address the needs of residents, HIQA said. The HSE said in response to the report that management and staff were fully committed to addressing all of the matters outlined in the report. It said that management had been addressing three alleged incidents of elder abuse by one staff member prior to HIQA inspection and had reported these to the chief inspector prior to the visit. "All allegations of abuse are considered to be a serious matter and any such allegation is managed under trust in care and elder abuse policies. In relation to the incidents of alleged abuse, the HSE acknowledges the findings in the report. Curently, a staff member is on leave pending investigation. Management wishes to provide assurance that any allegations which may arise in the future will be managed in a thorough and robust manner and in accordance with HSE policies and legislative requirements," it added. The HSE said it also noted the many positive findings and evidence of good practice contained in the report. "In particular, all residents interviewed by the inspectors expressed positive views on all aspects of the service and complimented the kindness and commitment of the staff."