The safety body HIQA has found that a Co Leitrim Nursing Home put 'do not resuscitate' orders in some residents' files without having discussed the issue with residents or families.

An inspection report into the Mullross Nursing Home in Co Leitrim reveals that despite these instructions being given, there was no evidence available that the home had ensured they had been discussed with the residents, or their relatives, or members of the care team.

The home, which was taken over by the HSE earlier this month, has now closed and the residents moved out.

The inspection report, based on visits to the Mulross home in December and January, uncovered issues of serious concern relating to the care of residents, including:

* Inspectors were concerned on the first day of the inspection regarding the fitness of the provider and person in charge and their ability to meet the needs of patients.

* There was a resident with a grade four pressure ulcer who was not receiving suitable safe care.

* An incident of unexplained bruising to a resident, which had been recorded in the care file, had not been documented on an incident report and had not been investigated.

* This centre had a significant period with no person in charge as the previous person in charge had resigned in September 2011 and the person in charge at the time of the inspection was not appointed to the post
until May 2012.

* Records relating to the monitoring of residents’ health status were inadequate.

* Many residents had not been weighed even though they had been losing weight and were on nutritional
supplements.

* Deficiencies in the care of a patient with epilepsy.

* Deficiencies in pain assessment and monitoring.

* The home had a a policy on ‘do not resuscitate orders’, which stated that there should be a discussion
with all relevant parties and the outcome documented. This policy also stated that residents who are not for resuscitation should have a care plan in place identifying how the decision was made and ensuring that regular evaluation occurs. There was no evidence that this was occurring.