Patients’ safety in old people’s homes is at risk from widespread inappropriate practices for dispensing and documenting medication, a nationwide audit has found.
Nearly half of old people’s homes have unsatisfactory documentation for medication and one in five do not dispense medication “appropriately”.
“Treatment charts were not signed when the actual medication was dispensed. Inappropriate dispensing and documentation of treatment may lead to errors, jeopardising patient safety,” the auditors noted.
The auditors are recommending that all homes ensure safe dispensing and documentation practices are adopted and adhered to. The observations were made in an audit of residential old people’s homes conducted by the Office of the Commissioner for Mental Health and Older Persons.
‘Medication practices unsatisfactory’
A specialist three-person team comprised of legal, social work and medical experts carried out the audit by visiting all 37 homes for the elderly across the country.
Handrails in corridors and bathrooms were present in less than half of all residences and one home did not even have a fire extinguisher on site. Only just over half of them had adequate anti-slip steps and floor surfaces.
“Homes need to step up their safety, in that they should install anti-slip measures and handrails throughout to decrease the risk of falls and the ensuing morbidity,” the auditors wrote.
Nearly 60 per cent of all homes had a formal agreement signed by the service provider and the resident stating the rights and obligations of both parties. The auditors felt all homes should adopt this practice, as well as encouraging residents’ autonomy and guarding their privacy to ensure they retained a modicum of independence.
While all homes provided meals in line with dietary needs, the auditors found that some offered dinner “far too early” because of logistical problems due to staff changes.
One in six homes failed to attain a score of 50 per cent for their general environment
They recommended that dinner should be served after 6pm and pre-bedtime snacks should be offered in homes that serve early dinners, especially to diabetics.
Most homes organised activities inside and outside their premises on a regular basis, but the auditors noted that participation was “extremely low”. The appointment of an activity coordinator in each home would go a long way towards addressing this, the report said. Observing that religious activities at homes were very well attended, the audit suggested that residences should take advantage of this to introduce initiatives immediately following worship, such as film screenings and choir singing.
It also noted that most homes did not provide prayer areas for non-Catholic residents, because there had never previously been a demand.
“Homes need to be aware that such requests are likely to arise sooner rather than later and need to plan how to tackle any such eventualities,” the auditors wrote.
One in six homes failed to attain a score of 50 per cent for their “general environment” relating to the building’s maintenance.
One in five scored below 50 per cent for staff friendliness and professionalism.
During their visits, the auditors were given tours of specific areas by the homes’ administrators. They also completed questionnaires through interviews with administrators and from their own observations.
The audit was tabled in Parliament this week as part of the office’s annual report 2013.