A nursing home in Ballinasloe has still not addressed high risk fire safety issues – two years after they were identified.

An inspection by the Health Information and Quality Authority (HIQA) has also criticised Aperee Living on Bridge Street in the town for its over dependence on agency staff due a significant reduction in nurses employed.

A Fire Safety Risk Assessment commissioned by Aperee Living in November 2021 found there was “no compartmentation” in the centre, which meant that all residents would have to be evacuated in the event of a fire.

There were deficiencies found in fire doors throughout the centre and windows in the bedrooms were permanently restricted from opening fully which put residents at risk if there was a fire.

While regular evacuation drills were being carried out, inspectors were not assured that the largest compartment, where 17 residents lived on the first floor, could be evacuated in a timely fashion.

Owned by the Cork-based investment firm BlackBee, management previously told HIQA that it would carry out fire safety works to contain smoke and fire and allow for the safe evacuation of residents during a fire emergency. But during an unannounced visit last April, HIQA inspectors found this had not begun and no information provided about when it would.

Some improvements had been completed, including a review of storage, availability of fire-fighting equipment in a designated smoking area, accurate signage for fire extinguishers, a review of directional signage and the removal of padlocks from external gates.

The centre is registered to accommodate 60 residents but had just 38 during the inspection. HIQA attached a condition to the home’s registration that it could not accept further admissions until the urgent fire safety problems were addressed.

The HIQA report also highlighted an insufficient number of registered nurses employed at the nursing home with no employed nursing staff on the majority of day shifts.

A review of the staffing rosters found that there were only four staff nurses employed by the provider available to work there, far below the 10 full-time registered nurses it had committed to in its statement of purpose.

“Inspectors were aware of issues in relation to paying outstanding agency bills. This model of reliance on agency staffing was not robust,” the inspectors pointed out.

Previous inspections raised red flags with general maintenance at the centre.

The building was found to be well laid out to meet the needs of residents and to encourage and aid independence. The centre was bright, warm, and well-ventilated throughout. Call bells were available in all areas and answered in a timely manner.

However, an enclosed outdoor garden continued to be in a poor state of repair, with leaves and weeds in the gutters and uneven footpaths which posed a falls risk to frail residents. Water damage to some of the rooms due to an ongoing roof leak and lack of painting continued to be ignored.

A number of resident toilets were locked restricting their access while the assisted bathroom was used as a storage area.

The picture was not all negative, the inspectors pointed out.

“In spite of the significant risks associated with fire safety, and the governance and management of the centre, residents were receiving appropriate person-centred care and support from a responsive team of staff,” they stated.

There had been “ongoing regulatory engagement” with Aperee and they had appointed a new Chief Executive Officer last January, but this person had since left.

“The provider had not ensured that the service provided was safe and met the needs of the residents living in the centre, particularly in terms of the arrangements in place for governance and management, fire precautions, staffing and the premises.

“Issues of serious regulatory concern had not been fully addressed since the last inspection, and additional issues in relation to the protection of residents were identified during this inspection, which further evidenced that the management structure in place was not sufficient to provide a safe service.”

“The organisational structures in place were not clear, with no clear lines of authority and accountability. The senior management team had changed a number of times in the months leading to this inspection.”

Aperee stated that it had recruited four oversees nurses and were applying for their visas. It also undertook to complete all outstanding fire safety risks by the end of November.