| Nursing Centre Statement of Purpose |
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STATEMENT OF PURPOSE
Registration Date: 25th January 2018 Registration No.: 12/02/0098 NAMES AND POSITIONS OF PERSONS PARTICIPATING IN THE MANAGEMENT OF CENTRE Service Provider: The Order of St. Camillus,
Administrator: Mrs. Marie Keaney,
Person in Charge: Bro. John O’Brien,
Assistant Director of Nursing: Mrs. Yvonne Lynam,
3 4 5 6 7
Fr. Stephen Foster, MI Further Education Includes:
Mrs. Marie Keaney
Bro. John O’Brien In 2000 Brother John took over the position of Director of Nursing. His role within the Nursing Centre is the co-ordination and facilitation of the Staff Nurses in the assessment, planning, implementation and evaluation of the care given to the residents; the facilitation of staff education; policy development; employment of staff and liaising between Nursing Centre and Relatives. Further Education includes:
Mrs. Yvonne Lynam Further Education Includes:
RESIDENT SAFETY - GARDA VETTING
STAFF ORGANISATION Registered Provider: Fr. Stephen Foster is the representative of the Order of St. Camillus. Fr. Stephen acts as the named Provider, to whom all members of staff are ultimately responsible. Administrator: Marie Keaney is responsible for the day to day administration of the Nursing Centre and is accountable to the Registered Provider. Person in Charge & Director of Nursing: Bro. John O’Brien is responsible for the day-to-day management of the Residents Care and is accountable to the Registered Provider. Assistant Director of Nursing: Yvonne Lynam has co-responsibility for the day to day running of the Nursing Centre and is accountable to the Director of Nursing. Registered General Nurses: Assess; Plan; Implement and Evaluate Care. Carers: Work under the direction of the Staff Nurses. They are responsible to the Nursing Staff.
Housekeeping: Mary Bray, team leader, responsible to the Director of Nursing. Catering: Caroline Schouten, catering supervisor, responsible to the Administrator. Laundry: Valerie Sheerin, team leader, responsible to the Director of Nursing. Dining Room: Elizabeth Connaughton & Marie Geoghegan, Dining Room Co-Ordinators responsible to the Director of Nursing. Activities Co-ordinator: Brigid O’Brien, responsible to the Director of Nursing. Grounds/Maintenance: Patrick Connaughton, responsible to the Administrator Volunteers: Volunteers working in the Nursing Centre are directly answerable to the Activities Co-ordinator, Brigid O’Brien. The Camillian Lay Family are also involved in the Nursing Centre. Medical Care: A resident may retain the services of their own GP. However this will depend on their willingness to accept the care of the resident while here in Killucan. The local G.P.s, based in Killucan Health Centre are led by Drs. Thomas Moore, Declan Brennan and Conor Ryan. Out of Hours services are provided by the HSE MIDOC service. The Psychiatry of Later Life Team based at St. Loman’s Hospital provides psychiatric/dementia care. Allied Professional Health-Care Personnel:
STAFFING IN WHOLE-TIME EQUIVILENTS: Registered Provider; Administrator 1; Director and Assistant Director of Nursing: 2. Nurses: 10.43; Care Assistants: 25. Catering: 5.03 Laundry: 2.2. Dining Room: 3.97, Housekeeping: 3.15, Maintenance: 0.75 Activities Co-Ordinator: 0.83 Our staffing compliment is supplemented by 20 volunteers. Our volunteers form an important link with the local community. They help in the dining room, with Bingo sessions, with the weekly Sonas session, mobile shop and other activities. They all have positive Garda Vetting.
St. Camillus Nursing Centre is a Catholic, not-for-profit facility, following in the spirit of St. Camillus de Lellis (1550-1614) who founded the Order of St. Camillus in 1591. The Order of St. Camillus has been providing care for people in the local area since 1935 and at the Nursing Centre since 1975. We aim to provide a high standard of care to people regardless of their cultural background or beliefs. We aim to create a caring, safe and supportive environment in which our residents can feel secure and their needs met. However, we acknowledge that although people need nursing care, the residents also have a right to a fulfilled life where they have meaningful activity and they are encouraged to live life to their full potential. We also appreciate that care of the family is equally important. We understand that coming to the realization that one can no longer provide the level of care a loved one requires at home is very difficult. We also understand the trauma of separation of people who have spent their lives together is a huge upheaval, both for the person needing care and equally for the person who may now have to face the prospect of living alone. During this time of initial separation we offer support to families by being available to them to give them time to express their fears and anxieties. At times we may feel it appropriate to invite a loved one to come in and share a meal with the resident, as they would have done at home. Residential care is a new way of living for people. Trust has to be earned, dignity maintained and a glimmer of hope always at hand. We aim to care for people by ensuring that we have the correct level of appropriately trained staff to meet the changing needs of the residents. A caring team of staff, who is appropriately trained and maintain their professional skills by continuous training and educational updates, ensures that the best possible care is provided for the resident’s. All members of staff participate in on-going educational programmes. Educational updates include: Lifting and Manual Handling. Wound Care Management. Documentation and Accountability. Fire Training. Dementia Care. Non-Violent Crisis Intervention. Infection Control. Hand Hygiene. Medication Management. Promotion of Continence. HACCP and Resident Centered Care Planning. However, we acknowledge that families will always remain the primary carer and no one will ever take their place. St. Camillus cares for adults of both sexes. It also facilitates two Palliative Care beds caring for adults in conjunction with the North Westmeath Hospice. Staff have received specialized training in the management of End of life Care, which is extended to every resident in the Nursing Centre. Care for people where there is no prospect of cure provides a particular challenge for the care-giver. We hope to find the balance of giving hope of a brighter tomorrow while at the same time not setting unachievable goals, this can be very challenging. The Nursing Centre caters for most forms of old-age related illnesses and conditions leading to a person’s inability to live un-supported at home. This includes people who require nursing care following a stroke or a heart attack as well as people suffering from Neurological conditions such as Multiple Sclerosis, Parkinson’s disease and Motor Neurons Disease. We care for people in the final stages of Cancer. We care for people with various forms of age related Dementia. We also care for residents requiring P.E.G. feeding tubes. As with all prospective residents, people with Mental Health problems will be admitted once we have assessed that we can fully meet their needs and can access the necessary back-up services when required. After establishing that we can meet their needs we may also provide care for people suffering from impaired judgment, decreased language skills and those with poor social skills and are unable to live independently. The Nursing Centre can only accept people with Acquired Brain Injuries, in people less than sixty-five years of age, once their Social/Psychological/Physical/Spiritual needs can be met at the Centre. This includes the guaranteed regular attendance at specialised day-care centres etc. Careful consultation will be made with the person’s family and the multidisciplinary team before we accept people in this situation. Nursing Care is tailored to the needs of the individual resident. The level of nursing care is dependent on the individual’s dependency level. This is assessed initially prior to admission by use of the Barthel Score and other information gained during the comprehensive Pre-Admission Assessment which is performed by either the Director or Assistant Director of Nursing. This will determine whether or not we can meet a person’s needs and accept them for admission in the first place. It will also determine their need for specialist equipment such as pressure relieving mattresses and seating as well as their need for the input from allied specialist services such as Speech and Language Assessment, Occupational Therapy, Physiotherapy, Psychiatry and Tissue Viability. Each resident has a comprehensive Care Plan in place, which informs staff of the resident’s needs; likes and dislikes. After admission a resident’s needs will be reassessed on at least a three monthly basis or more frequently if their condition changes and their Care Plan updated.
We offer residential care only. We aim to provide complete, twenty-four hour, holistic nursing care to both men and women. This includes social, psychological, spiritual and physical care. We also provide End of Life care in conjunction with the North Westmeath Hospice. Each resident is assessed prior to admission by either the Director or Assistant Director of Nursing, at a location suitable to them, to assess whether or not we can meet their individual needs, except for an admission by the Palliative Care Team. We will not accept a person for admission if this assessment demonstrates that we cannot meet their needs. We also require a medical transfer letter from the resident’s GP at home or Medical Team in the hospital as well as a medical prescription and a written description of their nursing needs completed by either the Hospital or Public Health Nurse as appropriate. We will accept adults under the age of sixty five, such as people with Acquired Brain Injuries, once we have assessed that we can meet their needs and there is an availability of allied services, such as Day-Care centres and physiotherapy. We also accept adults under the age of sixty five who are admitted by the Palliative Care Team. Generally, prospective residents and their relatives are invited to visit the Nursing Centre prior to admission. We accept people for short term respite care if a bed is available at the time but we do not offer a planned “book ahead” respite service.
FEES AND PAYMENTS The Residents contribution is paid monthly in arrears. It can be either paid by Standing Order or by Cheque / Cash to our Administrator. Cheques may be sent by post. The nursing staff does not accept or handle payments from relatives or residents. A resident holding a valid Medical Card is entitled to all the services the card provides but is liable for the Statutory Government Medication charge. A Contract for Care (Appendix 1) is issued to each resident. This outlines the services provided within the fee and those which are extra. It includes the terms and conditions of residence in the Nursing Centre. One copy must be signed and witnessed and returned to the administrator, the resident or their legal representative will also have a copy. The fees include all nursing care, laundry and in-house activities. They do not include items such as hairdressing, chiropody, physiotherapy (unless organised by arrangement with the HSE), and alternative therapies.
CARE PLANNING The resident’s Dependency Level is determined by a tool known as the Bartel Score, which is an assessment of a persons’ ability to care for themselves. This is combined with their Mental Test Score. The Bartel Score does not take into account cognitive ability / disability. Therefore, when estimating dependency both assessments are combined. EG: A resident who has a low dependency Bartel Score but has major cognitive impairment will have an overall High dependency. We also use Rhys-Hearn (1970) Dependency Tool to help us assess their dependency: Self Caring: Residents are continent; do not need assistance to the toilet. They can wash and feed and themselves. Residents can walk without assistance but may need an aid. They can manage their own affairs and make their needs known. Low Dependency: Residents may need supervision or assistance with washing and dressing. A person would not be confused and can communicate all their needs. They are continent but may have the occasional accident. Walks without assistance but may need an aid. They can manage their own affairs with little assistance. Medium Dependency: Occasionally incontinent and requires assistance in the toilet. Can feed themselves but may need minimal help. Needs supervision or assistance with washing, needs help with dressing, uses a walking aid and may use a wheel-chair. They require assistance with financial affairs and have difficulty making their needs known. High Dependency: The resident is sometimes doubly incontinent. Requires assistance in the toilet, uses a commode or requires incontinent care. Requires assistance or has to be fed. Requires washing and dressing. Walks with assistance or is bed/chair fast. Cannot manage their own affairs and cannot make their needs known. Weight and Vital Signs are recorded on admission and thereafter on a regular basis as clinically indicated. The Care Plan is updated in conjunction with the resident. We also incorporate the Assessments provided by the Local Area Placement Forum (the local body responsible for the assessment of prospective resident’s suitability for long-term Nursing Home Care) as well as the Barthel Score as used on the Preadmission Assessment. Twice yearly routine full blood screening is performed for our residents, with their consent, to monitor on-going well-being. Fortnightly INR monitoring is also performed at the Nursing Centre for residents on Warfarin therapy and the Warfarin dose adjusted by the local GP. As required microbiology tests are also performed. All laboratory services are provided by Longford and Westmeath Regional Hospital, Mullingar. Residents’ relatives will have an important role to play in the planning and delivery of care, especially in the discovery of residents likes and dislikes and what is “normal” for them. Both residents and their relatives are encouraged to be part of the ongoing Care Planning process. The Care Plan is always available to residents on request. The Care Plan also includes the residents (and/or their representatives as appropriate) wishes in regard to End of Life care. We provide a G.P. service to all residents including an “out of hours” service. In line with current legislation each resident has the right to retain a G.P. of their choice, once the doctor accepts the responsibility for their care.
DINING AND NUTRITION Individual diets, to suit the medical needs of residents, such as diabetic, renal or low sodium, are incorporated into the menu planning process. Our catering personnel are trained in the appropriate skills to do this, including HACCP. The Catering Facilities are inspected twice annually by the Environmental Health Department of the HSE. Coupled with this, we engage the specialist care of an HSE Speech and Language Therapist to assess residents with a decreased ability to protect their airway. A Dietician is also available to assess residents as indicated by clinical need. Our residents dine in two dining rooms. Two Dining-Room co-ordinator’s organize the residents dining experience. The menu is displayed daily with a choice for each meal in both dining rooms. Staff are available to assist residents as required. Volunteers also help in the Rebuschini Dining Room. A choice of beverages and snacks are brought to the residents three times a day. Fresh drinking water is available in all rooms and communal areas twenty-four hours a day. Meals can be arranged outside the normal dining times as required.
MEAL TIMES
Nursing, kitchen, dining room and care staff meet on a regular basis to ensure that all team members are aware of individual dietary needs. These might include, reduced or increased calorie diets, diabetic or renal diets.
OUTSIDE ACTIVITIES
IN-HOUSE ACTIVITIES We offer a range of in-house events and activities, which our residents may avail of if they wish. Residents are free to participate or not in any of the activities we provide.
Regular Activities Time Table (Subject to variation and addition) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Legion of Mary visit. Art and Craft One to One Sessions Visiting Live Music Group Pet Therapy Bingo at residents request Family day. Rosary Fit-for-Life The Saturday Match on TV Milie’s visit Cards evening T.V. T.V. Carmel’s one to one visits.
These include: Religious Services; Newspaper reading and discussion group four mornings a week; Twice weekly bingo sessions; SONAS sessions; Film afternoons; One to one dementia therapy; Music sessions at least three days a week; Weekly cards evening; Parties; Weekly Fit-For-Life exercise class; Pet’s visits; Evening musical shows. Junior Camillian Family Youth Group Visits. We also provide arts and crafts sessions, poetry reading and story-telling. A local newsagent provides daily newspapers if requested. Our Activities Coordinator plans our events to meet the needs of the residents, including one to one sessions for people who have a cognitive impairment. The weekly confectionary and small-goods shop is run by the residents with the aid of a volunteer.
LAUNDRY
RESIDENTS GROUP & INFORMATION The Group meets once a month, on the first Tuesday. The group sets its own agenda and is chaired by one of the residents. The Chairperson is voted into office by the residents. The Group is made up of residents, members of staff from each department, relatives and interested volunteers from the local community. To ensure the freedom of discussion the group does not include anyone from the Management Team. Minutes are kept by the Activities Co-Ordinator. All issues raised at the meetings are brought back to the Management Team and are dealt with in a timely manner. Likewise, we also use the group to elicit views on issues relating to the running of the Nursing Centre. We will keep residents who are not members of the Residents Group, and their relatives, informed with any developments and matters arising out of the Group. The minutes are available to be read by anyone who wishes to do so.
EMERGENCY PLAN A Standby Generator is in place to automatically click-in should the power fail. It is tested weekly and provides enough power to maintain all electrical equipment including lighting, heating, and fire detection. Everyone in the building has the responsibility to report, immediately, any situation that poses a risk to the residents and other users of the building. In the event of having to evacuate the Nursing Centre, the Camillian Residence within the grounds, is the designated building in which to accommodate residents until further arrangements can be made. This building contains four very large rooms and a lift with is serviced regularly.
FIRE PREVENTION The Fire Alarm system is serviced quarterly and the Fire Extinguishers are tested annually on a contract basis. The Fire Alarm and Fire Doors are tested at 12pm every Tuesday. Fire Training / Drill is provided twice a year by a trained and competent person. The Nursing Centre maintains a Fire Safety Register for inspection. New staff are trained within the first week of employment. Three addressable Fire Alarm Panels (one at each nurse’s station and one in the Front Hall) alert staff to the site of an incident in the event the fire alarm sounds. A monthly, unannounced, fire drill is performed to ensure staff react to the fire alarm appropriately. Under mattress Ski Sheets are in place on beds in rooms 1 to 9, 28 & 29 as the beds cannot come out of the rooms. These facilitate the movement of residents from these rooms in the event of an evacuation. The integrity of these is checked and recorded every two months. Staff are trained on their use.
EMERGENCY EXITS
EMERGENCY EVACUATION If in Doubt – Evacuate! If Evacuation is necessary the Nurse in Charge must alert: The first priority of evacuation is to move residents to a place of safety out of immediate danger, using Progressive Horizontal Evacuation from one compartment to the next. To ensure a speedy evacuation the following is the order in which to evacuate residents: • Ambulant residents requiring only one person to guide/assist them. • Non-ambulant residents who need to be physically moved, wheeled or carried.
EVACUATION TECHNIQUES Various pieces of equipment may be used to facilitate speedy evacuation EG: Wheelchairs, blankets or sheets, beds, ski-sheets. Choose the method most appropriate to the resident. Due care must be taken during the evacuation process with all residents in so far as is possible to minimise the risk of harm to anyone.
PRINCIPLES OF EVACUATION: Phase 1. Evacuation from the room or area where the danger lies to a place of relative safety in another zone within the building, past a set of fire doors in the case of fire. Close all doors behind you. Phone all members of staff who can help. Phase 2. When the Emergency Services arrive they will take charge of the situation – FOLLOW THEIR INSTRUCTIONS. Phase 3. Evacuation of whole sections of the building into non-hazardous areas, EG an area beyond a set of fire doors not affected by Fire or Flood. Close all doors behind you. Phase 4. Evacuation of everyone in the building by the nearest exit to the Assembly Point. Stay at the Assembly Point (in the car park in front of the Church) until told to move and everyone is accounted for. There is Sensor and Emergency lightening all around the building. One member of staff must be detailed to stay with them at all times to make sure they are safe outside the building. They must take the Duty Folder, Resident Profile Box, representatives’ details, dependency and mobility status and Visitors Log with them. Do not re-enter the building unless you are told to do so. Phase 5. When instructed move all residents from the Assembly Point into the designated external building.
A roll-call should be performed to ensure all residents, visitors and members of staff are accounted for. Nobody should re-enter the building until they are told to do so by the Emergency Services. The HSE Director of Community Care (9340221) should be notified that an evacuation has taken place as soon as possible to aid in finding emergency accommodation for the residents. Within three working days H.I.Q.A. must be notified that an Evacuation has taken place.
FAITH PRACTICE We have an Internet Web Link to the Chapel, which gives a live 24hr view of the front of the Chapel. The public can participate in the services, including daily Mass, via the Internet at our website www.orderofstcamillus.ie Residents of other denominations are welcome to have their own minister’s call whenever they wish. We also facilitate religious services of other Christian denominations in our chapel. All ministers of religion are welcomed and facilitated. Non-Christian residents are welcome to practice their faith too and we shall facilitate them to the best of our ability. Many local people use the chapel for worship, especially on Sunday’s, and so help to create a parish environment for our residents.
PASTORAL CARE We have a Mortuary Chapel, off the main chapel. A much-valued service offered by the Nursing Centre is the Removal Mass, which we see as our final tribute to a resident. The staff always form a guard of honour as a resident and their family leave the chapel. For many years we have expressed our sympathy to families and our farewell to residents at the removal in the church. It is a service that also serves the local community. Many local families appreciate and make use of the chapel to wake their loved ones. Residents like to participate in this final act of recognition and care. Every November we hold a Memorial Mass for residents who have died, to which their relatives are invited. This is very much in keeping with the traditional remembrance of the dead during November.
GROUNDS AND GARDENS
SMOKING POLICY
PLEASURE TRIPS
VISITORS We can facilitate visitors who have to come at meal times by arranging for residents to have their meals with their visitors in their rooms. Residents may receive telephone calls on a hands-free telephone whenever they wish. Visitors are welcome to help themselves to refreshments while they are here in the Rebuschini Room. Residents are always welcome to hold birthday parties and other family gatherings here. The Nursing Centre provides a large and spacious room in which families can meet and celebrate together. While our catering facilities are geared towards our residents we can offer a limited catering facility for family gatherings, notice is naturally required prior to any larger event. We uphold the right of residents and their relatives to restrict their visitors to whomsoever they wish to see, especially when a person is nearing the end of their life. We will, in so far as is possible, monitor residents visitors in these situations and if necessary ask people not to visit. Visitors in the late evenings may be reminded of the need for awareness of others should the hour become late. Visitors to residents who are dying are welcome at all times. Visitors to the Nursing Centre may be reminded that should they feel unwell or appear to have flu-like symptoms that they not visit in the interest of the health of our frail and vulnerable residents. We may also restrict visiting in the event of an outbreak of conditions such as the Norovirus. This will be done in accordance with current HSE Infection Control guidelines and Nursing Centre policy. Indiscriminate visiting of the Nursing Centre is not permitted. We expect visitors to the Nursing Centre to act in a respectful and appropriate manner. Antisocial and abusive behavior will not be tolerated and a person acting in this way will be asked to leave and further action may be taken to prevent abusive and aggressive behaviour. Staff members are always available to meet prospective residents and their families to give them a tour of our facility and to answer any questions they may have as well as to explain our services.
PARLIAMENTARY PROCESS
COMPLAINTS PROCEDURES
Policy Statement: We recognize the importance of the family in the care of our residents and seek to empower them. It is most important that they have ease of recourse to those responsible for the good running of our facility. Any complaints or comments about the service will be used to evaluate the care we provide. It is seen as an important contribution to improving the overall quality of our care. It will be used to contribute to the on-going quality improvement and risk management of the services we provide.
Purpose: To ensure that all members of staff, residents and their families or representatives are aware of the complaints procedure. Scope:
Responsibility:
Guidelines: 1. All complaints should be received with attention and understanding and should be dealt with, in the first instance, on the spot. While a complaint may be made to any member of staff, they should always be referred on to the nurse in charge of the shift. 2. The nurse in charge should take the person to a private room to discuss the complaint. All complaints should be received with sympathy. 3. If the situation can be resolved immediately, do so. If an apology is required, make one. We all make mistakes. 4. If the person making a complaint is not happy with the initial outcome the Director of Nursing, Brother John O’Brien, will take over the investigation of the complaint. 5. The Director of Nursing, Brother John O’Brien, will then contact the person making the complaint by telephone and may follow this up by letter. The Director of Nursing may request that the complaint be then made in writing for further investigation. 6. If the complaint involves a situation of abuse the appropriate action will be taken as defined in the ABUSE POLICY. 7. All complaints involving a named member of staff must be in writing. The written complaint must name the person and be situation specific. 8. If a written complaint is received the Director of Nursing will reply within 5 working days. 9. The Director of Nursing will explain that an investigation will be undertaken and that a written response can be expected within 30 working days. It should be explained to the person making the complaint if there is a reason why this deadline cannot be met and an estimated date given. 10. Once the Director of Nursing has dealt with the complaint the Assistant Director of Nursing will review the situation to ensure the appropriate procedures have been followed. 11. The Director of Nursing will contact the person making the complaint to ensure they are satisfied with the outcome and that the resident is also satisfied. 12. All complaints and concerns will be shared with our staff as appropriate to ensure that the situation does not happen again and that our service can be improved. 13. We will ensure that the person making the complaint is protected and does not suffer from any form of bullying as a result of making a complaint. 14. The Director of Nursing will maintain a record of all complaints, their investigation and outcome for a period of not less than seven years after the investigation and resolution. This will facilitate improving the quality of the care we give and our future policy planning. 15. The Administrator reviews all complaints on a monthly basis to ensure that we handle complaints appropriately. Finally, we accept that sometimes a person raising a concern or making a complaint may not be satisfied with the outcome from Nursing Centre. If the Nursing Centre is unable to resolve a complaint to the satisfaction of the person making the complaint it can be referred to an external independent person for further examination. This process will be dealt with through the Administrator, Mrs. Marie Keaney, who will arrange for a meeting with the external arbitrator. Our external arbitrator is Madeleine Clarke, Joristown, Killucan, Co. Westmeath. Tel: 086-85776205. Ms. Clarke is a psychologist and an Executive Director of GENIO which is a not-for-profit organisation working with public, private and social sector organisations. It supports and promotes innovative approaches to ensure that people at risk of social exclusion are supported to live full lives in their communities. A person making a complaint may also wish to refer the situation to H.I.Q.A., The Ombudsman or the Local HSE Director of Community Care if they believe that there has been an unsatisfactory outcome at Nursing Centre Level. Their contact details are prominently displayed within the Nursing Centre. The Director of Nursing will also ensure that a person making a complaint is aware of these contact details. Complaint Procedures and the Ombudsman If you have complained to us and you're not satisfied with our decision on your complaint it is open to you to contact the Office of the Ombudsman. The Ombudsman provides an impartial, independent and free service. By law the Ombudsman can examine complaints about any of our administrative actions or procedures as well as delays or inaction in our dealings with you. The Ombudsman's remit relates to complaints about actions which occur on or after 24 August 2015. The Ombudsman cannot examine complaints about actions which occurred before that date with the exception of complaints from residents eligible to complain under "Your Service Your Say" (Residents whose place is provided under a contract with the HSE). The Ombudsman, 18, Lower Leeson St., Dublin 2 Tel: 1890-223-030 / 01-639-5600 Emial: This e-mail address is being protected from spambots. You need JavaScript enabled to view it On-Line: www.ombudsman.gov.ie / We encourage our residents to be as independent as possible but our residents must feel free to ask for help whenever they need it. Residents can lock their doors if they wish.
EXTERNAL APPOINTMENTS Unless there is a clinical need for a nurse from St. Camillus Nursing Centre to accompany the resident we would ask relatives/representatives to arrange an escort to hospital appointments.
THERAPY Due to the limited access to HSE community services some of these services may have to be funded privately by the resident or availed of outside the Nursing Centre as appropriate. The residents may request any therapy they may wish to avail of, and we will endeavor to organise it for them. Services covered by the fee are outlined in the Contact of Care.
DIGNITY All staff members will try to maintain a resident’s dignity so that they are aware of the need to knock before entering a room/bathroom when a resident is being cared for. Our staff will ask permission before carrying out any care-giving activity and procedure. If a resident feels uncomfortable with any aspect of their care or with the person giving the care we seek to change the manner in which care is provided. Post is distributed daily. Each resident is provided with a lockable area in their bedside locker in which they can keep their belongings. A safe is provided in the Nursing Centre office in which residents can also keep valuables and a small amount of cash. A record of these deposits is maintained.
WASTE DISPOSAL
KEY POLICIES
Governance of the Nursing Centre is organised through the implementation of policies and procedures. The Key Policies are the following:
Recognizing and Responding to Elder Abuse Management of Accounts and Personal Property Communication End of Life Care Recruitment Nutrition and Dehydration Provision of Information to Residents Retention of Records Food Safety Health, Safety, Welfare and Environmental Policy Risk Management Medication Management Policy Complaints Procedure Procedure for a Resident Missing from the Nursing Centre Temporary Absence Emergency Policy Evacuation Plan Behaviour Management Admissions
REGISTRATION AND LICENCE TO OPERATE
Appendix 1 - Contract of Care
THIS AGREEMENT is made this day of 2012
BETWEEN
St. Camillus Nursing Centre, Killucan, Co Westmeath (hereinafter the ‘Proprietor’)
AND
(hereinafter the ‘Resident’)
WHERAS
A. The Proprietor operates a nursing home providing long-term residential care services which is on the Register of Nursing Homes established under the Health (Nursing Homes) Act 1990 as amended.
B. The Proprietor is the person whose name is entered on the Register of Nursing Homes pursuant to the Health Act 2007 (Registration of Designated Centres for Older People) Regulations 2009 as carrying on the business of nursing home care services at the Nursing Home and the Nursing Home is a designated centre within the meaning of Section 2 of the Health (Nursing Homes) Act 1990 as amended.
C. The Resident requires the long-term residential care services to be provided by the Proprietor pursuant to the terms and conditions of this Agreement.
D. The Resident is a person who has/has notbeen approved by the Health Service Executive to receive Nursing Home Support Scheme to the amount of……. per week, …….per day from……………. Yours contribution per week is ……………
E. Both the Proprietor and the Resident confirm that this Agreement shall be entered into within one month of the Resident entering the Nursing Home in accordance with requirements of the Regulations.
F. It is agreed by the Parties that this Agreement shall comprise all terms and conditions concerning the care and welfare of the Resident in the Nursing Home and fully sets out details of the services to be provided by the Proprietor to the Resident during the course of this Agreement and the fees to be charged therefor.
NOW IT IS HEREBY AGREED AS FOLLOWS:
1. Definitions
1.1 The following terms shall have the following meanings for the purposes of interpreting this Agreement unless the context otherwise provides:
‘Act’ shall mean the Nursing Homes Support Scheme Act 2009, as may be amended from time to time.
‘Commencement Date’ shall mean the date …………………..
“Force majeure event” shall exist if either Party is hindered in the performance of its obligations pursuant to this Agreement or in the preparation for such performance, as a consequence of war, the threat of war, riot, nuisance, fire, water damage, flood, strike, sit down strike, lock out, import or export embargoes, defective machinery, disruptions in the provision of energy, as well as for any other cause that is not within the control or scope of risk of the party concerned.
‘Guarantee’ shall mean the guarantee executed between the Proprietor, the Resident and the Resident’s surety prior to the execution of this Agreement.
‘Nursing Home’ shall mean the Proprietor’s nursing home situated at Killucan, Co Westmeathwhere the Proprietor shall provide the Services to the Resident.
‘Party’ or ‘Parties’ shall mean the Proprietor and/or the Resident as the proper context may allow.
‘Regulations’ shall mean the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 as may be amended from time to time.
‘Services’ shall mean the services which the Proprietor shall provide to the Resident more particularly set out in Schedule 1 to this Agreement.
1.2 Words importing the singular number shall include the plural and vice versa and words importing the masculine gender only shall include the feminine and neuter genders and words importing persons shall include firms, corporations, trusts, companies and incorporated and unincorporated bodies. Marginal notes and headings herein are inserted for convenience only and shall not affect the construction or interpretation hereof.
1.3. The preamble and all appendices or schedules to this Agreement form an integral and substantial part of this Agreement. This Agreement sets out the entire agreement between the Parties and shall supersede all prior discussions between the Parties and all statements, representations, terms and conditions, warranties, proposals, communications and understandings whenever given and whether orally or in writing by one Party to the other or by any Party to any third party.
2. Services
2.1 The Proprietor shall, for the duration of this Agreement, provide to the Resident the Services and undertakes to provide the Resident suitable and sufficient care to maintain the Resident’s welfare and wellbeing having regard to the nature and extent of the Resident’s dependency and needs, which services may, as appropriate, be provided by the Proprietor to the Resident under the direction of a General Medical Practitioner from time to time.
2.2 In the provision of services to the Resident, the Proprietor shall use its best endeavours to comply with the Regulations and all applicable legislative provisions governing the provision of long-term residential care to residents of Irish private/voluntary nursing homes.
2.3. The Proprietor shall ensure that the Resident’s needs are at all times set out in an individual care plan which shall be developed and agreed between the Resident and the Proprietor, its servants or agents.
3. Fees
3.1 Where the Resident is in receipt of the Services specified in Paragraph A of Schedule 1 to this Agreement the fees payable by the Resident to the Proprietor are set out in Paragraph A of Schedule 2 to this Agreement.
3.2. Where the Resident is in receipt of the Services specified in Paragraph B of Schedule 1 to this Agreement, the fees payable by the Resident to the Proprietor are set out in Paragraph B of Schedule 2 to this Agreement.
3.3 The fees set out in Schedule 2 of this Agreement may be reviewed and revised by the Proprietor on an annual basis or where there is a change in the dependency needs of the Resident upon service of ten days written notice by one Party on the other.
3.4 Where the Resident leaves the Nursing Home voluntarily during any period in respect of which the fees under this Agreement have been paid, the said fees shall not be refunded by the Proprietor to the Resident, except as may otherwise be agreed between the Parties.
3.5 If through death, permanent hospitalisation or unforeseen permanent discharge, a Resident leaves the Nursing Home during a period for which the fees have been paid, the said fee may be refunded by the Proprietor to the Resident or any person lawfully appointed under law or by the Resident to act for and on behalf of the Resident.
3.6 In the case of fees being paid or supported through the liquidation of assets through the offices of solicitors, accountants, courts or other bodies, suitable undertakings shall be provided for and on behalf of the Resident.
3.7. The Resident confirms that he has duly executed with his Surety the Guarantee in favour of the Proprietor and hereby acknowledges that such Guarantee is a condition precedent for entering into this Agreement.
4. Duties of the Proprietor
The Proprietor shall ensure that the Proprietor, servants, agents or assigns shall:
4.1. ensure that where medical treatment is recommended by a medical practitioner and agreed by the Resident that such treatment is facilitated;
4.2 ensure that the Resident is provided with facilities for the occupation and recreation of all residents;
4.3 ensure that the Resident is provided with privacy, insofar as is reasonably practicable;
4.4 provide the Resident with information concerning current affairs, local matters and community resources;
4.5 provide the Resident with arrangements to facilitate, insofar as is reasonably practicable, the exercise of his civil, political and religious rights;
4.6 carefully consider any suggestion from the Resident or from his family or other relevant persons to maximise his comfort and care;
4.7 ensure that the Resident is free to communicate at all times, having regard to his and other residents’ well being, safety and health;
4.8 ensure that appropriate arrangements are made for the Resident to receive visitors;
4.9 investigate any bona fide complaint made by or on behalf of the Resident and communicate the result of such investigation to the complainant in accordance with established complaints policies and procedures;
4.10. ensure that the Resident has access to a safe supply of fresh drinking water at all times and is provided with food and drink and quantities adequate for the Resident’s needs;
4.11 ensure that any dietary restrictions applying to the Resident on medical or religious grounds shall be facilitated;
4.12 provide facilities for the Resident’s personal property, jewellery and other belongings and monies and maintain a full written record of thereof;
4.13 ensure that all reasonable measures are taken to protect the Resident from all forms of abuse; and
4.14. ensure that in all cases the dignity of the Resident shall be respected.
5. Duration and Termination
5.1. This Agreement shall commence on the Commencement Date and shall terminate in accordance with the provisions hereof.
5.2. Either Party may terminate this Agreement by notice in writing, delivered or dispatched by registered mail to the other Party hereto, not less than four weeks prior to the date upon which such termination becomes effective. Where the Resident terminates this Agreement without providing notice in accordance with this Clause, the Resident shall pay to the Proprietor the following fee in lieu of notice [Proprietor to insert amount].
5.3 The Proprietor shall have the right to terminate this Agreement with immediate effect in the event that:
(i) the Resident becomes disruptive and/or aggressive towards any other Resident of the Nursing Home and/or any member of staff of the Nursing Home; or
(ii) the Proprietor forms the opinion that the Resident’s behaviour is a risk to the health and safety of any Resident of the Nursing Home and/or any member of staff of the Nursing Home; or
(iii) any situation whatsoever arises whereby the Proprietor is incapable of operating the Nursing Home or is unable to provide the Services in the Nursing Home..
The Resident acknowledges that the Proprietor shall have the right to exercise its right under this Clause at its sole discretion either with or without consultation with appropriate State authorities and/or the Resident’s next of kin.
5.4 The Proprietor shall have the right to terminate this Agreement with immediate effect in the event that the Resident fails to pay all sums due and owing under this Agreement pursuant to a demand made by the Proprietor to the Resident in accordance with Clause 7.6 of this Agreement.
6. Requirements for the Resident
6.1 The Resident shall upon admission and during the duration of this Agreement comply with the following obligations. The Resident shall:
(a) present all medications to any person appointed by the Proprietor (including the Director of Nursing or person in charge of the Nursing Home) upon admission to the Nursing Home;
(b) take all reasonable steps to ensure that visitors and relatives do not bring into the Nursing Home medication or food or alcohol for consumption or use by the Resident without the prior consent of the Proprietor;
(c) ensure that his clothing and belongings are clearly marked and/or labelled with the Resident’s name or initials;
(d) comply with all or any arrangement agreed between (i) the Proprietor and (ii) the Resident and/or any person on behalf of the Resident with regard to smoking and alcohol consumption in the Nursing Home;
(e) comply with all reasonable requests and suggestions made by the Proprietor;
(f) ensure the punctual payment within 21 days of a demand by the Proprietor of all fees or sums due or owing to the Proprietor under this Agreement;
(g) advise the Proprietor in advance within twelve weeks should the Residents funds necessary to pay the Proprietor punctually for all fees and sums become depleted;
(h) appoint a medical practitioner of his choice and duly notify the Proprietor thereof;
(i) nominate a next of kin upon arrival at the Nursing Home, which person shall be contacted by the Proprietor where considered necessary under this Agreement;
(j) observe all rules laid down by the Proprietor for the orderly operation of the Nursing Home; and
(k) ensure that the detail required for the Admission Form in the form set out in Schedule 3 to this Agreement are duly completed and up to date.
6.2 The Resident may leave the Nursing Home either permanently or temporarily provided that:
(i) the Resident gives such notice as may be prescribed by the Proprietor from time to time.
7. Powers of the Proprietor
The Resident agrees that the Proprietor at all times, in accordance with all applicable legislative and regulatory requirements, may:
7.1 discuss the condition of the Resident with any person nominated by the Resident or any representative acting for and on behalf of the Resident and medical practitioners including doctors or nurses associated with the care of the Resident or to any other person nominated by the Resident or at the discretion of the Proprietor;
7.2 restrict visits by all persons in times of illness or distress of the Resident or under the direction of the medical practitioner where such restriction is considered to be in the best interest of the Resident;
7.3 after consultation and with the consent of the Resident assign any room in the Nursing Home to the Resident. However, it is acknowledged by the Resident that the Proprietor, servants and assigns may require the Resident to move rooms within the Nursing Home when considered necessary or appropriate by the Proprietor for the safety of the Resident or any other Resident of the Nursing Home;
7.4 transfer the Resident to an alternative nursing home(s) and/or hospital(s) if in the opinion of the medical practitioner it is in the interest of the Resident to do so; and
7.5 review and agree with the Resident fees chargeable under this Agreement where considered necessary or in the event that additional Services are required by the Resident; and
7.6 if for whatever reason, the Resident is not entitled to, or ceases to receive financial support under the Act, demand payment directly from the Resident for all services provided to the Resident under this Agreement and the Resident agrees to discharge all such sums within four weeks of such demand by the Proprietor.
8. Severance
If any provision or clause of this Agreement is or becomes void or unenforceable in whole or in part for any reason whatever such unenforceability or invalidity shall not affect the enforceability or validity of the remaining provisions or clauses or part thereof contained in this Agreement and such void or unenforceable provisions or clauses shall be deemed to be severable from any other provision or clause or part thereof herein contained.
9. Force Majeure
The Resident agrees that the Proprietor shall not be responsible or liable for any loss, inconvenience, injury or damage suffered by the Resident or caused to his property as a result of a Force Majeure event.
10. Independent Legal Advice
The Resident acknowledges and confirms that:
(i) he, or any person lawfully appointed to act on his behalf, has received independent legal advice on the duties and obligations arising under this Agreement and the Guarantee prior to their execution; or
(ii) he, or any person lawfully appointed to act on his behalf, having been given a reasonable opportunity to obtain independent legal advice, has waived his/their right to receive such independent legal advice on the duties and obligations arising under this Agreement and the Guarantee prior to execution.
11. Variation
No variation or alternation to this Agreement shall apply unless such variation or alteration has been agreed in writing and signed by both Parties in accordance with the terms of this Agreement.
12. Exclusion Clause
12.1 The Resident agrees that the Proprietor, servants or agents shall not be liable for any personal injury howsoever caused to the Resident within the Nursing Home where the Proprietor, servants or agents act in accordance with all legislative and regulatory requirements.
12.2 The Proprietor shall not be responsible or liable for any injury or loss suffered by the Resident outside the Nursing Home, its gardens, grounds or confines where the Proprietor, servants or agents act in accordance with all legislative and regulatory requirements. However, the Proprietor confirms, in accordance with Part 7 of the Regulations that the Proprietor has ensured that all providers with whom the Proprietor has entered into contractual relations, holds appropriate insurance in respect of loss or damage to the assets of the Resident and the delivery of services to him.
12.3 The Proprietor shall not be responsible or liable for the theft by any person whomsoever of any property or valuables of the Resident which have not been given to the Proprietor by the Resident for safe keeping.
13. Governing law and Jurisdiction
This Agreement shall be governed by and construed in accordance with the laws of the Republic of Ireland and the parties hereto hereby submit to the exclusive jurisdiction of the courts of the Republic of Ireland.
IN WITNESS HEREOF this Agreement has now been entered into the day and year first above written.
SIGNED BY OR BEHALF OF
THE PROPRIETOR
St Camillus Nursing Centre]
___________________________
In the presence of: Proprietor
______________________
Name of Witness
______________________
Address of Witness
SIGNED BY
THE RESIDENT
___________________________
Resident
In the presence of:
______________________
Name of Witness
_______________________
Address of Witness
Signed on behalf of the Resident _____________________________
In the presence of:
______________________
Name of Witness
_______________________
Address of Witness
Schedule 1
The Services to be provided by the Proprietor to the Resident.
Paragraph A
Where the Resident is a person who has been approved to receive State Support in accordance with the Act:
1. The Proprietor shall provide to the Resident the following Services:
(a) Bed and board;
(b) Nursing and personal care appropriate to the level of care needs of the Resident;
(c) Bedding other than specialist beds;
(d) Laundry Service
(e) Basic aids and appliances necessary to assist the Resident with the activities of daily living;
2. The Proprietor and the Resident also agrees that the Proprietor shall provide any or all of the following Services * to the Resident for such further remuneration as may be agreed between the Parties:
a) All therapies;
(b) Incontinence wear;
(c) Chiropody;
(d) Dry cleaning;
(e) Ophthalmic and Dental Services;
(f) Transport (including care assistant costs);
(g) Specialist wheelchairs;
(h) Hairdressing and other similar services;
(i) Social programmes;
(j) Daily delivery of newspapers; and
(k) Any other service that may be agreed between the Parties.
* The Parties to this Agreement understand that the Services referred to in Paragraph A.2 (a) to (k) inclusive above may be provided to the Resident by the Proprietor and/or any third party service provider with whom the Proprietor has a contractual relationship in accordance with:
(i) all applicable legislative and regulatory requirements; and
(ii) the fee/cost paying arrangement agreed between the parties.
In all cases where the Resident is a private patient of a medical practitioner, the supply of drugs and medication will also be private and the appropriate charge will be made.
Paragraph B
Where the Resident is a person other than a person who has been approved to receive State Support in accordance with the Act:
1. The Proprietor shall provide to the Resident the following Services:
(a) Bed and board;
(b) Nursing and personal care appropriate to the level of care needs of the Resident;
(c) Bedding other than specialist beds;
(d) Laundry Service
(e) Basic aids and appliances necessary to assist the Resident with the activities of daily living;
2. The Proprietor and the Resident also agrees that the Proprietor shall provide any or all of the following Services * to the Resident for such further remuneration as may be agreed between the Parties:
a) All therapies;
(b) Incontinence wear;
(c) Chiropody;
(d) Dry cleaning;
(e) Ophthalmic and Dental Services;
(f) Transport (including care assistant costs);
(g) Specialist wheelchairs;
(h) Hairdressing and other similar services;
(i) Social programmes;
(j) Daily delivery of newspapers; and
(k) Any other service that may be agreed between the Parties.
* The Parties to this Agreement understand that the Services referred to in Paragraph B.2 (a) to (k) inclusive may be provided to the Resident by the Proprietor and/or any third party service provider with whom the Proprietor has a contractual relationship in accordance with:
(i) all applicable legislative and regulatory requirements; and
(ii) the fee/cost paying arrangement agreed between the parties
In all cases where the Resident is a private patient of a medical practitioner, the supply of drugs and medication will also be private and the appropriate charge will be made.
Schedule 2
FEES
Paragraph A
Where the Resident is a person who has been approved to receive State Support in accordance with the Act, the fees payable by the Resident to the Proprietor for the Services specified in Paragraph A of Schedule 1 to this Agreement shall, with effect from 1 January 2011 or from the date on which the Resident enters the Nursing Home (whichever date is the later), be the sum equal to the Maximum Permissible Amount as may be agreed from time to time between the Proprietor and the National Treatment Purchase Fund.( Copy of state support letter attached)
Paragraph B
Where the Resident is a person other than a person who has been approved to receive State Support in accordance with the Act, the fees payable by the Resident for the Services specified in Paragraph B 1( a-e) of Schedule 1 to this Agreement are as follows:
Fees per week as of date €740.00
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