Hiqa critical of dementia care in St. Patrick's Hospital, Cashel Co. Tipperary

Person in charge provides a 'quality service for all residents'

Eoin Kelleher


Eoin Kelleher


Hiqa critical of dementia care in St. Patrick's Hospital, Cashel Co. Tipperary

St Patrick's Hospital in Cashel

St Patrick’s Hospital, Cashel has received a mixed report from the Health Information and Quality Authority (Hiqa), being deemed ‘non-compliant’ in five out of six categories assessed in relation to dementia care.

St Patrick’s is located on the Cahir Road in Cashel, and caters to 95 residents, with seven vacancies at the time of inspection. Hiqa is tasked with carrying out inspections on all care facilities in the state to ensure compliance with standards.

A two-day unannounced inspection was carried out on St Patrick’s on July 23 and July 24 this year. The report was published on Friday last, November .

The report sets out the findings of an unannounced thematic inspection that focused on six specific outcomes of dementia care.

The inspector noted that the provider representative and the person in charge were committed to providing a “quality service for all residents including people with a diagnosis of dementia”.

However, the centre did not have a dementia specific unit and at the time of the inspection there were 41 people living in the centre with a formal diagnosis of dementia.

The inspector viewed that some residents required “a high level of support and attention due to their individual communication needs and dependencies.

“While all care staff had responsibility to help residents exhibiting aspects of responsive behaviours, observations demonstrated that some staff did not actively engage in a positive connective way to enhance their quality of life.”

The inspector deemed the facility to be ‘Non Compliant - Moderate’ in Health and Social Care Needs; ‘Non Compliant - Moderate’ in Safeguarding and Safety; ‘Non Compliant - Major’ in Residents' Rights Dignity and Consultation; ‘Substantially Compliant’ in Complaints Procedures; ‘Non Compliant - Moderate’ in Suitable Staffing; and ‘Non Compliant - Moderate’ in terms of Safe and Suitable Premises.

The report states: “There were three staff on the activities team and activities were varied and activities staff showed good insight regarding promoting individualised activities to enhance peoples' quality of life. Observation and discussion with staff demonstrated that not all staff understood or provided person centred care. Consequently, institutional practices, with rigid daily routines were evident, which resulted in significant negative outcomes for some residents. The inspector observed that there was inadequate staff supervision to ensure that appropriate care was delivered that enabled quality of life and safe care for residents.”

The inspector found that residents’ healthcare needs were met. Residents had access to general practitioners (GPs) and support services such as advanced nurse practitioner (ANP) candidate for dementia care, living well with dementia project and memory technology library, memory clinic, neural psychologist, geriatrician, psychiatry, physiotherapy, pharmacist, speech and language therapists and community health services were also available.

However, “the design and layout of the centre was not fit for purpose and could not meet the needs of residents due to lack of communal and private space, multi-occupancy bedrooms, inadequate storage for residents' personal property and possessions, and lack of storage for equipment.”

Also, a sample of staff files reviewed demonstrated that staff files did not contain a vetting disclosure in accordance with the National Vetting Bureau Act 2012.

The full report can be read at the website