Standards at nursing home criticised

Staff at a HSE-run nursing home in Co Waterford only became aware of the outbreak of an infectious disease at the centre five days after it began, a report by the health services watchdog reveals.

Inspectors from Hiqa have sharply criticised standards at Dunabbey House in Dungarvan, which included the failure to manage an outbreak of the winter vomiting bug last December until five days after the first resident had contracted the infection.

Hiqa said the overall findings of an unannounced inspection of the facility, which operates under the management structure of the Dungarvan Community Hospital, demonstrated poor compliance with legislation governing the care and welfare of residents.

Hiqa inspectors said five days had elapsed after the outbreak of the vomiting bug before control measures were put in place.

They claimed the facility had failed to enforce its own policy for the management of infectious diseases by failing to isolate a patient with symptoms. Another resident had subsequently contracted the bug as a result of sharing a bedroom with an infected patient.

The report noted that no cleaner was on duty at Dunabbey during three days of the outbreak, while it criticised the management for failing to notify the chief inspector of the outbreak as required under legislation.

The inspection, which was carried out over two days last March, was in response to information received by Hiqa which outlined a number of concerns regarding the quality of life for residents.

Hiqa officials said there were insufficient numbers of staff to adequately supervise or meet the needs of the home’s 29 residents, particularly in the evening.

Inspectors found the centre’s statement of purpose did not provide an accurate reflection of the profile of residents as Dunabbey is only meant to provide services for residents assessed as low-medium dependency.

They noted that at least two residents had a high dependency and should have been transferred to Dungarvan Community Hospital or another nursing home.

They also said the management structure did not ensure clear accountability for adhering to regulatory responsibility or sufficient supervision of care.

Although residents said they felt safe in the centre, Hiqa said it was clear from records that they had expressed fear for their safety on occasions due to the challenging behaviour of other residents which had resulted in physical altercations and minor injuries.

They also noted that not all members of staff were adequately trained in the prevention and detection of elder abuse, manual handling, or fire safety.

Other problems identified were records which failed to provide evidence that the fire system and emergency lighting were serviced annually, and the failure to have residents’ medication reviewed every three months by their GP.