The Health Information and Quality Authority (HIQA) has published an overview report of monitoring activity undertaken in St. Joseph’s Hospital, Ennis during 2017. St. Joseph’s Hospital is a designated centre for older people, operated by the Health Service Executive (HSE).

St. Joseph’s Hospital was first registered as a designated centre for older people in June 2012 and findings of regulatory non-compliances were consistently found over the course of six inspections between 2012 and 2016. The HSE failed to take proactive actions to address the issues identified and failed to put a coherent and sustainable plan in place to improve the quality of life for residents in St. Joseph’s Hospital.

On 16 January 2017, HIQA issued a proposal to renew the registration of St. Joseph’s Hospital with a condition to restrict any further admissions to the centre for a period of time until the provider could demonstrate that “the privacy, dignity and quality of life needs of residents’ currently residing in the centre, are met”. The HSE was informed that an application to remove this condition could be made when residents’ rights were met. The HSE appealed the decision to restrict admissions to Ennis District Court.

Three inspections were carried out in April, September and November 2017 to inform court proceedings, and to monitor progress in dealing with the regulatory non-compliances. Sustained regulatory non-compliances were identified on these inspections in the areas of residents’ rights dignity and consultation; residents’ clothing and personal property and possessions; safeguarding and safety; governance and management; health and safety; risk management; and safe and suitable premises. By November 2017, incremental improvements were noted in the culture of the centre, with the most significant improvements as a direct result of the reduction in the number of residents accommodated on two units, the Hazel and the Alder Units:

• the culture of the centre moved from a medical model of care grounded in institutional practices towards a social model of care.
• there was a significant increase in the amount and variety of social activities available to residents and, as a result, an increased number of residents were participating in activities to enhance their quality of life.
• significant structural improvements were made in the Ash Unit, and these were positively impacting on residents’ quality of life.
• additional communal and dining space was provided.

Notwithstanding the noted improvements and the actions undertaken by the HSE, further work is required. The HSE must continue to promote a home-like environment, ensuring access to a living space that facilitates improved privacy and dignity for residents and the reduction and elimination of institutional practices. HIQA also remains concerned about the sustainability of improvements made to date.

Escalated regulatory activity in St. Joseph’s Hospital, Ennis concluded in December 2017 when the centre was registered with two additional conditions applied to its registration. The purpose of these conditions is to improve the quality of life for all residents living in St. Joseph’s Hospital, Ennis and to ensure the HSE continues to address regulatory non-compliance. The HSE must now progress their plans to replace this centre with a purpose-built centre within a defined time bound implementation plan.

HIQA will continue to monitor St. Joseph’s Hospital, Ennis to ensure the improvements in regulatory compliance that have been achieved during this period of escalated regulatory activity are sustained and that the HSE continues to implement its own improvement plan.

Ends.

For further information please contact:

Marty Whelan, Head of Communications and Stakeholder Engagement

(01) 814 7480 / 086 244 7623 mwhelan@hiqa.ie

Notes to Editor:

• HIQA independently regulates designated centres for older people for compliance with the Health Act (2007) Regulations and the National Standards for Residential Care Settings for Older People in Ireland (2016), to ensure that the people living in these services are safe and well looked after.
• St. Joseph’s Hospital, Ennis is registered to accommodate a maximum of 120 residents providing 24-hour nursing care long-term, short-term, respite, rehabilitation, palliative, and dementia care needs. Over the course of the three inspections, the number of residents accommodated in St. Joseph’s Hospital rarely exceeded 100.
• St. Joseph’s Hospital has had a history of consistent failure to comply with the regulations, with non-compliances repeatedly reported since the centre was first registered in 2012. These regulatory failings meant that residents living there did not have their rights to privacy and dignity upheld and they were not facilitated to live active lives, free of institutional practices and regimes.