Failure to Provide Adequate ADL Assistance for Grooming and Hygiene
Penalty
Summary
The facility failed to ensure that activities of daily living (ADLs) were completed for three residents, specifically in the areas of grooming, nail care, haircuts, and showers. One resident was observed with unkempt and matted hair, overgrown yellow fingernails with black debris, and expressed a desire for assistance with hair brushing and nail trimming. This resident was assessed as cognitively intact and dependent on staff for bathing and personal hygiene, with a care plan indicating the need for staff assistance in these areas. Despite these needs, the resident's grooming and hygiene were not adequately maintained. Another resident reported dissatisfaction with the length of their hair and the lack of available haircuts, noting that a beautician had not been present for several weeks. Staff interviews confirmed that the facility previously had a beautician who provided regular haircuts, but due to the beautician's absence, hair care services had lapsed. The process for residents to request haircuts was described, but it was also acknowledged that no beautician was currently available, and efforts to secure a replacement were ongoing. A third resident was observed with significant facial hair and stated a preference for being shaved, which was not consistently provided. Documentation and interviews revealed inconsistencies in the provision and recording of shaving assistance, with some shower logs lacking information on whether shaving was completed or if refusals occurred. The resident's care plan and progress notes did not address shaving needs or refusals, despite the resident's moderate cognitive impairment and dependence on staff for personal hygiene. The facility's ADL policy requires that residents unable to perform ADLs receive necessary services to maintain grooming and hygiene, but these requirements were not met for the residents reviewed.