HIQA conducted an unannounced inspection of St Columcille’s Hospital and found the hospital to be compliant or substantially compliant with 10 national standards and partially compliant with one national standard assessed during inspection. Inspectors found while some governance structures, such as committee reporting arrangements had been strengthened since the previous inspection, several senior management positions were vacant, and existing governance arrangements were not sustainable in the long term. Hospital management submitted a compliance plan to HIQA outlining how they will address these findings. 

The effectiveness of the healthcare provided in the hospital was systematically monitored, evaluated and improved. Systems were also in place to protect patients from known risks of harm that were the focus of this inspection. Complaints were well managed and staff had introduced several initiatives to improve patients’ experiences. Inspectors found that staff provided a person-centred approach to care, with an evident culture of kindness, consideration and respect. It was clear to inspectors that patient feedback was valued by staff at the hospital. 

Inspectors conducted an unannounced inspection of Cavan Monaghan Hospital and found the hospital had achieved a high level of compliance with 10 of the 11 National Standards for Safer Better Healthcare assessed to be compliant or substantially compliant and one standard was found to be partially compliant.

The inspectors found evidence of strong corporate and clinical leadership. The senior management team was responsive and reactive, particularly on issues that impacted patient flow and effective discharge planning. Although there were increased attendances at the emergency department (ED), the team worked to manage the situation in line with the hospital’s escalation plan. However, overcrowding in the ED impacted patients’ dignity, privacy and autonomy.  

Inspectors noted that there were no delayed transfers of patient care, and the average length of stays for medical and surgical patients were compliant with HSE targets. People who spoke with inspectors were positive about their care experiences and were very complimentary of staff, describing them as kind, friendly and helpful.

HIQA’s unannounced inspection of Midland Regional Hospital Portlaoise found the hospital to be compliant or substantially compliant with six national standards assessed and partially compliant with five national standards. 

Governance and management arrangements were in place however, two committees were not meeting in line with their terms of reference leading to potential gaps in the coordination and integration of risk management and quality activities across committees and departments. Since HIQA’s previous inspection an uplift in medical and nursing staff resourcing was observed, however challenges remained in filling positions in the quality and patient safety and pharmacy departments. These staffing shortfalls had affected complaints management and the provision of clinical pharmacy services. 

The hospital promoted a person-centred approach to care. Inspectors observed staff being kind and caring towards patients who spoke positively about their care experiences and were very complimentary about staff. Despite increased attendances at the ED, performance compared well in relation to national targets for patient experience times and in the context of fewer numbers of approved ED consultants supporting the service compared with other model three hospitals with similar attendances. 

Although elements of the compliance plan relating to the environment had been addressed since the last inspection, the use of multi-occupancy rooms and poor availability of isolation rooms were largely unchanged. Overall, while positive findings were identified in relation to the monitoring, evaluation and use of data to improve healthcare outcomes, further work is required to address resourcing, oversight and governance.

HIQA’s announced inspection of Ballina District Hospital found the hospital to be compliant or substantially compliant with nine national standards, and partially compliant with two national standards assessed. 

While inspectors found that there were some formalised corporate and clinical governance arrangements in place for Ballina District Hospital, opportunities were identified for improvement. For example, there was no regional community forum where medication safety would be regularly reviewed and evaluated or where issues could be escalated and managed. This was identified in a previous HIQA inspection in 2020. Inspectors found that staff attendance at and uptake of mandatory and essential training in hand hygiene could be improved. Nevertheless, inspectors observed staff actively engaging with patients in a respectful and kind way, and this was validated by patients who were very complimentary of the service. Inspectors also noted that the physical environment of the clinical areas supported patients’ privacy, dignity and confidentiality. 

Overall, while examples of good practice were observed, further work is required to advance areas identified for improvement from management at Ballina District Hospital in conjunction with management in the community health region. 

HIQA’s announced inspection of Castlecomer District Hospital found the hospital to be compliant or substantially compliant with eight of the National Standards for Safer Better Healthcare assessed and partially compliant with three national standards. 

Areas identified for improvement included the requirement to review and address comprehensive management arrangements for the service. While the age of the hospital premises challenged the delivery of care, the hospital’s physical environment was clean and well maintained. Single rooms were available for patients, particularly patients at end of life and for patients who required transmission-based precautions. Inspectors identified good local ownership and oversight in relation to infection prevention and control. 

Inspectors also found that staff promoted a culture of kindness, consideration and respect and the dignity, privacy and autonomy of patients was well respected. Monitoring arrangements were effective in identifying opportunities for improvement, and quality improvement initiatives were implemented. Systems were in place to identify, manage, respond to and report on patient-safety incidents. There was evidence that lessons learned were shared with staff and that incidents were discussed at meetings. 

HIQA carried out an announced inspection of Wicklow Community Unit on 1 and 2 August 2024. The hospital was found to be compliant or substantially compliant in nine standards and partially compliant in two of the 11 national standards monitored.

Governance arrangements were in place for assuring the delivery of high-quality, safe and reliable healthcare, relevant to the size and scope of this unit. Workforce arrangements were planned, organised and managed with further work required regarding resourcing and training to ensure the delivery of high-quality care. 

Patients’ dignity, privacy and autonomy were respected and promoted. Management and staff promoted a culture of kindness, consideration and respect. The hospital had systems in place to effectively respond to complaints. The physical environment supported the delivery of high-quality care with some exceptions which were highlighted to the manager on the day of inspection.

The unit monitored the quality and safety of care regarding medication safety and infection prevention and control with areas for improvement identified on inspection including the progression of single room facilities for management of suspected infections and the development of comprehensive quality improvement plans for follow up of audit findings. 

HIQA’s announced inspection of the Royal Hospital Donnybrook found the hospital to be compliant or substantially compliant with nine standards and partially compliant with two national standards assessed. 

Corporate and clinical governance and management structures were integrated and appropriate for the size, scope, and complexity of the services provided. Oversight and monitoring arrangements were in place for risks of harm that are the focus of each HIQA inspection. In addition, while effective staffing arrangements were in place and minimal vacancies were reported, there was no clinical pharmacist and deficiencies were found in mandatory training compliance.

The hospital had a system in place to identify and respond to patient deterioration. Medication management policies and local policies regarding infection prevention and control needed revision and full implementation. While the physical environment was spacious and clean, inspectors found there was a limited number of single rooms in the hospital. 

Inspectors noted evidence of a strong commitment to promoting kindness, consideration, and respect in patient care. Patients consistently reported that they were treated with kindness and respect by staff and expressed satisfaction with the courtesy and attention they received. 

HIQA carried out an announced inspection of Beaumont Hospital and the hospital was found to be compliant or substantially compliant in seven standards and partially compliant in four of the 11 national standards monitored.

The hospital had formalised governance arrangements for assuring the delivery of high-quality, safe and reliable healthcare. However, these arrangements were not fully effective at the time of inspection to manage the mismatch between service demand and hospital capacity. This resulted in an overcrowded ED, non-compliance with HSE targets patient experience times (a metric used by health services to quantify the length of time patients wait in ED before they are either discharged or admitted to hospital) and accommodating admitted patients in the ED. While risk management processes were in place for mitigation, risks still existed in the design and delivery of services. For example, pharmacy staffing shortages impacted the provision of clinical pharmacy services to all clinical wards. 

The hospital had systematic monitoring arrangements for identifying and acting on opportunities to continually improve the quality, safety and reliability of healthcare services. Inspectors observed that staff communicated with patients in a manner that respected their dignity and privacy. However, the ED’s challenging environment did not adequately support all patients’ dignity and privacy. The hospital responded promptly, openly and effectively to complaints, and systems were in place to systematically monitor and evaluate the services. The hospital effectively identified, managed, responded to and reported on patient-safety incidents.  

The physical environment of the clinical areas visited on the day of inspection were generally clean, but there was evidence of general wear and tear with some areas in need of refurbishment. Overall, while management at Beaumont Hospital had formalised corporate and clinical governance arrangements in place for assuring the delivery of healthcare, improvements are required to ensure that arrangements are effective to manage the mismatch between service demand and hospital capacity which was seen on the day of inspection.