THE HSE continues to work with HIQA to improve standards at St Camillus’ Hospital, according to area manager Bernard Gloster.
He was commenting on an inspection that found “moderate” non-compliance in the area of food and nutrition and “minor” shortcomings in end-of-life care at the residential unit for the elderly on Shelbourne Road.
HIQA made an unannounced inspection focused on these two themes on November 7.
Inspectors noted the concerns expressed by staff over the withdrawal of the dietician services last July. The report went on to state that in the absence of such a service, staff were administering nutritional supplements that were not prescribed to residents who had experienced weight loss or gain.
“Staff voiced their concern at the lack of availability of dietetic advice. Based on the findings on the day of inspection, the inspector was of the view that current practices posed a risk to residents,” the HIQA report stated.
The HSE responded to HIQA that it had since engaged a private company to provide dietetic services.
And commenting to the Limerick Leader this week, the HSE said it had to be noted “that having a dietician is not a feature of all public and private facilities”.
“What is of equal importance is the management and delivery of catering and the training of nursing and care staff in the many aspects of care that make up the overall requirements in respect of food and nutrition. We will continue to use the input of a dietician subject to availability and need and while the restrictions on recruitment in public services remain a factor, the public can be assured money is not an issue in this specific instance,” a spokesman said.
The November 7 visit by HIQA was a “thematic inspection” focused on end-of-life care and food and nutrition at St Camillus’ Hospital rather than an overall assessment.
Such a specific inspection was welcomed by the HSE “in getting into the detail and action required in pursuing excellence in all of the national standards, for which in the case of services for older people in residential care there are 32”, a spokesman said.
But the overall picture at St Camillus’ in recent years had been one of steady improvement, according to Mr Gloster.
“In reading a themed report such as this it is particularly important the public understands that there is a wider context to the service and such reports. One only has to go back 10 month from this report to an overall inspection of St Camillus’ over two days in which all 18 outcomes (examined by HIQA) were assessed,” he said.
That assessment had noted that “significant progress had been made on addressing issues identified on the previous inspection”, he pointed out.
The overall picture of St Camillus’ presented by HIQA in February 2013 had welcomed the provision of separate dining facilities, a call-bell system and the “tasteful refurbishment” of all residential units.
“The improvements were well received by residents, relatives and staff. Care practices had improved and these changes were monitored by the management team on an ongoing basis. The audits conducted showed marked improvements in the manner in which restraint was used and the attention paid to personal care.
“There was a perceptible change in culture in the centre; a change from a medical model to a more person-centred, social model of care. Staff were seen interacting and talking with residents in a respectful and friendly way. There was an emphasis on placing the resident at the centre of care decisions,” HIQA had noted in its last full inspection of the facility.
“There is little doubt,” Mr Gloster said, “that we must continue to derive the benefit of external regulation and inspection. This benefit comes as we continuously improve care as set out in the national standards. There will always be room for improvement.
“However, the public can be reassured from the overall assessment quoted directly from the HIQA report. It is most important that we have a culture which recognises deficits and demonstrates capacity to correct them through ongoing change.”