HIQA’s unannounced inspection of Mayo University Hospital found the hospital to be compliant or substantially compliant in eight national standards and partially compliant in five of the 13 national standards assessed.

Several improvements were noted since the last inspection, such as the reconfiguration of the quality and safety department, recruitment of quality and patient safety personnel, and the introduction of a patient advisory liaison service. While the times for patients to progress through the emergency department (ED) had improved since the last inspection, they remained outside of HSE targets.

Hospital management was identifying and acting on opportunities to continually improve the quality and safety of healthcare services at the hospital. There had been a significant increase in medical staffing at junior and consultant level in the ED since HIQA’s last inspection. However, there continued to be vacancy rates above 10% in the healthcare assistant, nursing and health and social care professional roles.

HIQA was satisfied that the hospital had systems and processes in place to respond promptly, openly and effectively to complaints and concerns raised by people using the service and noted good practice in relation to in-house patient satisfaction surveys.

The hospital had increased ED capacity since the last inspection and inspectors found that patient privacy and dignity was supported for patients accommodated in individual cubicles and multi-occupancy rooms. However, for patients placed on trolleys along the corridor, the promotion of privacy and dignity was limited. While HIQA notes the improvements made since the last inspection across the hospital, further improvements were needed to improve patient experience in the ED.

An unannounced inspection of Sligo University Hospital found the hospital to be compliant or substantially compliant in five national standards and partially or non-compliant in eight of the 13 national standards inspected.

The hospital had systematic monitoring arrangements in place for identifying and acting on opportunities to continually improve the quality and safety of all services. However, recommendations and areas for improvement identified by audit and monitoring activity required implementation to ensure improvements in practice occurred. The hospital had improved medical staffing levels in the ED which will have a significant positive impact. However, shortfalls in the nurse staffing in ED were having an impact on optimal staffing complement for day and night shifts, and inspectors found limited improvement from the last inspection in September 2022. 

HIQA identified further opportunity for improvement of the operational oversight and management of patient flow issues through the ED. While inspectors found that there were no patients aged 75 years or more in the ED over 9 hours, none of the other HSE targets in relation to time taken for patients to progress through the ED were met on the day of inspection. 

Patients who spoke with inspectors were positive about their experience of receiving care in the ED and wider hospital and were very complimentary of staff. Despite staff efforts to maintain patients’ dignity and respect, the practice of accommodating inpatients on trolleys on the ED corridor and on ward corridors and or treatment rooms impacted on patients’ dignity and privacy. While the hospital management team had committed to make improvements, there was limited progress on the hospital’s compliance with the national standards since the last inspection and this needs to be progressed. 

On this inspection, HIQA found the rehabilitation unit to be compliant or substantially compliant with nine national standards and partially compliant with two national standards assessed during inspection. While monitoring and audit activity in the unit required improvement, HIQA found generally good levels of compliance on the day of inspection. Activities in the unit were designed to encourage independence and to help patients integrate back into activities of daily life. Patients who spoke with inspectors were complimentary of staff, aware of their plan of care and felt involved in decision-making.

HIQA’s announced inspection of Clontarf Hospital found the hospital to be compliant or substantially compliant in all 11 national standards assessed on inspection. Clontarf Hospital had formalised corporate and clinical governance arrangements in place for assuring the delivery of high-quality, safe and reliable healthcare and had systematic monitoring arrangements in place for identifying and acting on opportunities to continually improve the quality and safety of all services. 

HIQA was assured that hospital management was identifying and acting on opportunities to continually improve the quality and safety of healthcare services at the hospital. However, there was scope to consider increasing the level of audit activity relating to transitions of care. 

HIQA found Carlow District Hospital to be compliant or substantially compliant with 10 national standards and partially compliant with one standard on the day of inspection.  
Staff in Carlow District Hospital promoted a person-centred approach to care and patients who spoke with inspectors were very complimentary of staff and the care received in the hospital. Carlow District Hospital also had systems and processes in place to respond effectively to complaints and concerns raised by patients and or families. The hospital’s physical environment and staffing levels also supported the delivery of high-quality, safe healthcare.

Carlow District Hospital had management and monitoring arrangements in place to support and promote the delivery of safe, high-quality healthcare and to continually improve and minimise risks to patient safety. The hospital’s governance arrangements were being revised and reconfigured at the time of inspection to further strengthen integration with community services and align with regional governance structures. 

HIQA found the National Rehabilitation Hospital in Dún Laoghaire to be compliant or substantially compliant with nine national standards and partially compliant with two national standards assessed during inspection. Areas of improvement were identified relating to unfilled staff positions across a range of disciplines to support comprehensive rehabilitation programmes. In addition, hospital management should also keep out-of-hours medical cover arrangements under continuous review, particularly in the context of long-term ventilated patients and the planned increase in bed capacity. There were a number of controls in place at the hospital to reduce these risks; however, hospital management need to ensure that these risks are formally and regularly reviewed and evaluated.  

Despite these areas for improvement, a culture of kindness, consideration and respect was evident in the hospital and promoted by a number of practices. For example, patients were encouraged to set goals and be active decision-makers in their plan of care. People who spoke with HIQA inspectors were positive about their experience of receiving care in the hospital and were very complimentary of staff. The physical environment in the clinical areas visited supported the delivery of high-quality, safe, reliable care and protected the health and welfare of people receiving care, especially vulnerable patients.