Deficiencies at Belfast care home put residents with diabetes at risk, reveals watchdog
Residents of a Belfast care home have been put at risk amid failures to properly manage their diabetes, it can be revealed.
Officials have raised concerns about the care of people living at Hawthorn House after it emerged some were not getting vital medication for diabetes on time.
In one disturbing case, there were delays in treating a raised blood sugar level in a resident.
People with hyperglycemia - raised blood glucose levels - can fall into a coma or even die if swift action is not taken to return the blood sugar to a safe level.
Hawthorn House, owned by Four Seasons Health Care, is in east Belfast and provides nursing care to older people and people who are terminally ill. An inspector from the Regulation and Quality Improvement Authority (RQIA) carried out an unannounced visit on July 5 and found a number of failings that could have fatal consequences for the residents involved.
Staff on duty at the time of the inspection reported "feeling under significant pressure specifically on days whenever one nurse was on duty with the support of a care home assistant practitioner (CHAP)".
The RQIA report said: "Discussion with the manager and staff, in addition to observation of care delivery to patients, evidenced that staffing arrangements were not appropriate to meet the need of patients. This particularly concerned the care of patients with diabetes and those requiring oxygen therapy.
"Despite concerns being escalated to the manager, the concerns were not effectively addressed. There was limited evidence of formal supervision and appraisal of staff."
As well as delays in administering medication to a number of residents with diabetes, the RQIA inspector also found that medicine records for the patients had not been completed in an accurate and timely manner by the registered nurse.
The report continued: "Misleading information concerning one patient's blood glucose reading was provided by care staff.
"The elevated blood sugar of one patient was not managed in a timely and effective manner by the registered nurse. It was also found that communication between nursing and care staff on duty in regards to the care of these two patients was ineffective and/or contradictory.
"It was further evidenced that care delivery to one patient receiving oxygen therapy was managed ineffectively by staff.
"This had the potential to impact the welfare of the patient."
The report also said that communication between staff regarding the management of the resident was inadequate, which resulted in nursing staff having an inadequate understanding of the patient's needs.
The inspector raised concerns about the issues, but was not satisfied that they were being addressed quickly enough to a proper standard, the report added.
The RQIA issued two failure to comply notices and ordered management at the home to address the issues by August 22.
Paula Bradshaw, Alliance Party health spokeswoman, said that following the litany of failings uncovered at Dunmurry Manor, the findings of the inspection at Hawthorn Home would add to the deep sense of concern regarding the care provided to some of the most vulnerable people in Northern Ireland.
"While I hope this issue can be swiftly addressed, how can we be assured that other conditions are being properly managed in care homes too? This is an issue of human dignity and care homes now need to be much higher priority for regulators."
A spokesman for Four Seasons Health Care said: "We take our responsibilities as a care provider very seriously and regret that the RQIA found aspects of care that we needed to improve.
"A new registered manager is now in post and we have enhanced the clinical support into the home through our quality and governance teams.
"We have put in place an improvement plan which will address the areas of concern identified including a review of the medication management and other care documentation, together with close management oversight to ensure that our procedures are correctly followed and records are complete, contain comprehensive information and are up to date.
"We have reviewed the number and skills mix of staff and how they are deployed on each shift, to ensure that they are appropriate to meet residents' needs."