A Letterkenny nursing home recorded a number of non-compliances according to a new HIQA report.
Details of a HIQA inspection at Archview Lodge nursing home in Letterkenny carried out in February were released this week, with issues relating to infection control, governance and management and the premises raised in the course of the inspection.
Inspectors noted that residents living there “were well-cared for, and supported to live a good quality of life by staff who were kind and caring,” and the centre was found to be compliant or substantially compliant in 11 of the 14 categories that were inspected.
However, a number of issues were identified in relation to infection control, which according to the report “…had the potential to impact the effectiveness of infection prevention and control within the centre.”
The report stated that there was “poor oversight” of environmentql hygiene, and that the centre was “visibly unclean” on the day of the inspection.
“There was poor oversight of the quality of environmental hygiene. The centre was visibly unclean on the morning of the inspection, including floors, walls, doors, door frames, doors saddles on corridors, communal toilets and bathrooms, the staff room, storage areas and dining areas. There was evidence of dust and debris on high and low surfaces,” according to the report.
Other concerns included “worn and poorly maintained” wall paintwork, wood finishes and flooring that “did not facilitate effective cleaning,” an “unclean, cluttered and disorganised” sluice facility, an inadequate layout of the cleaning room, items of equipment used by residents such as shower chairs and hoists being “in a poor state of repair and visibly unclean,” inadequate practices by staff when handling soiled linen which “posed a risk of cross-infection to the resident,” unclean nebuliser masks and compressor machines, and the inappropriate storage of items.
The centre’s governance and management was also found to be non-compliant, with the report stating they were “not fully effective.”
“The provider’s own internal management systems of audit and oversight have failed to identify the significant concerns found on this inspection in respect of infection control, medication management and premises,” the report said.
Concerns in this area relating to risk management and inadequate oversight of training and staff supervision were also raised.
“For instance, the inspectors identified that the water in all sinks was observed to be very hot on the day of the inspection. The maintenance staff addressed this before the end of the inspection,” inspectors wrote.
“There was inadequate oversight of training and staff supervision, in particular, infection prevention and control practices.”
The facility was also found to be non-compliant with guidelines relating to its premises.
For example, inspectors noted that the layout of four twin-occupancy rooms “did not ensure that residents
had sufficient space to store their clothes,” which led to wardrobes being “inappropriately placed in en-suite bathroom facilities.”
Inspectors also noted that there were no call-bell devices available in the communal areas and in some bedroom, which “poses a risk that when residents require help or
assistance, they won’t be able to alert staff,” according to the report.
Access issues relating to the residents’ courtyard, storage management and the need for painting and repair of certain items of furniture were also noted by HIQA.
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Despite these non-compliances, overall the report stated that residents praised the staff and their level of care, and that staff were observed providing care in a “respectful and calm manner.”
“Residents were complimentary about staff and the care they provided. Staff were observed to be familiar with the needs of residents, and to deliver care and support in a respectful and calm manner. There was a calm and welcoming atmosphere in the centre over the course of the inspection,” the report read.
The provider in charge of Archview Lodge provided several responses to HIQA regarding the non-compliances found in their report.
As relates to the infection control non-compliance, the provider stated:
“As detailed in the urgent compliance plan submitted following the inspection, the Registered Provider implemented immediate and sustained actions to strengthen governance, oversight, and management systems within the Centre,” their response read.
“An immediate deep clean of the entire centre was completed under the supervision of the Person in Charge (PIC), with records maintained. This included all communal areas, clinical rooms, equipment, and high-touch surfaces. To address deficits identified, the Registered Provider has strengthened governance systems and oversight arrangements, including the implementation of a robust audit schedule: Daily environmental and cleanliness spot checks, Weekly infection prevention and control (IPC) audits and Monthly governance and management reviews – to discuss Audit findings, Risks and incidents, Compliance with policies and procedures and Progress against the centre’s quality improvement plan.”
A full hygiene audit was also carried out by the provider, with improved staff training programmes put in place, as well as a review of housekeeping resources, the commencement of the repainting and redecoration of all bedrooms in the facility, a deep clean and reorganising of the sluice room, engagement with the HSE’s infection prevention and control team, and more.
Relating to the Governance and Management non-compliance, the centre said in the report:
“Following the inspection, the Registered Provider has undertaken a comprehensive review of governance and management systems to ensure effective oversight across all areas of the service. An immediate deep clean of the centre was completed under the supervision of the Person in Charge (PIC), with records maintained. This addressed the immediate risks identified in relation to infection prevention and control.”
“Governance and oversight arrangements have been strengthened through the implementation of a revised audit schedule, including: Daily environmental and cleanliness spot checks, Weekly Infection Prevention & Control (IPC) audits, Medication management audits and Monthly governance and management review meetings The monthly governance meetings involving the Registered Provider, PIC and ADON to review: Audit findings, risks and incidents, compliance with regulations and progress against the centre’s Quality Improvement Plan.”
“The Registered Provider has engaged an external professional cleaning company, who have completed a full audit of environmental hygiene and IPC practices. The centre is currently implementing the recommendations identified, and updated cleaning policies and procedures have now been received and will be implemented following review by management. The external provider will also support ongoing staff training and provide scheduled deep cleaning services. Management oversight has been strengthened through: Daily oversight by the PIC and ADON, including environmental walk-throughs, Clear allocation of staff responsibilities to maintain a clean, safe and clutter-free environment and review and implementation of documented cleaning schedules,
including all resident equipment.”
“Staff training and supervision have been enhanced – all staff completed in-person IPC refresher training, nurse nominated to complete IPC Link Nurse training and ongoing staff supervision, spot checks and team meetings to reinforce standards.”
“A review of housekeeping resources has been completed, with additional supports secured through the external cleaning provider.”
“Environmental and premises risks identified have been addressed or are being progressed within defined timeframes, and medication management practices are subject to regular audit and oversight. All actions are ongoing and will be fully embedded by 31st August 2026.”
The provider also confirmed that numerous works have been completed to address the non-compliance relating to the premises, including the development of plans to remove wardrobes from en-suite facilities, a wireless call bell system which has been installed throughout all areas of the nursing home, the repair of the external courtyard gate, and significant refurbishment works relating to interiors across the centre, as well as furniture.