AN INSPECTION REPORT at a Louth nursing home in which over 20 patients died during a Covid-19 outbreak in April has highlighted several concerns about the standards and regulations adhered to at the nursing home.
On 27 May, the first of a two-day inspection was carried out by the Health Information and Quality Authority (Hiqa), the results of which were published today along with 30 other inspection reports.
Dealgan House in Dundalk town provides 24-hour nursing care to around 80 adult residents.
After speaking to residents and staff, observing daily practices and reviewing documentation, the conclusion of the inspection was that it wasn’t compliant in six main areas (it was deemed ‘compliant’ or ‘substantially compliant’ in 15 other areas).
The first was on staffing. The report found that the nursing home hadn’t the appropriate number and skill-mix of staff.
The second was on training and staff development in relation to Covid-19:
…the person in charge had not ensured that all staff working in the centre had attended all of the required additional Covid-19 infection prevention and control training. Records showed that not all staff had attended the training video in relation to donning and doffing (putting on and taking off) personal protective equipment (PPE).
The third issue of compliance was in the issue of governance. During the Covid-19 outbreak in Dealgan House in April, more than 60% of all staff, including 70% of the nursing staff, were unable to work due to contracting Covid-19.
Although the Covid-19 contingency plan was activated, staffing levels continued to fall as more staff contracted the virus and were unable to work. This led to staff from the HSE community and acute services to be redeployed to the centre to ensure that adequate numbers of staff were available to provide care and services for the residents.
Written policies and procedures had also not been updated to include the latest HPSC infection prevention and control guidance on Covid-19.
On infection control, the report said:
Not all staff had attended up-to-date training and refresher courses in infection prevention and control in line with HPSC guidance.
Inadequate oversight of staff practices in infection control, for example: staff travelling to work in their uniforms; staff gathering in the foyer the entrance and not adhering to social distancing guidelines; not all staff checked their temperatures on arrival for work and again; during the working day in line with HPSC guidance
There was no clear protocol in place to ensure that all staff knew what to do in the event of a suspected case of Covid-19 presenting in the designated centre.
A sixth issue was identified by the report under the headline ‘health care’:
“…Inspectors were not assured that residents were being monitored twice daily in order to detect signs and symptoms of potential Covid-19 infections early.”
This practice was required as part of the HPSC guidance to ensure that signs and symptoms were detected promptly, and that appropriate infection prevention and control measures were put into place early.
While temperatures were taken twice per day, in the past they were only logged if
abnormal. Temperatures are now logged without exception twice per day, the report said.
In a statement issued today in response to the report, Dealgan House Nursing Home said it welcomed the publication of the Hiqa Report of an inspection which took place on 27 May – just a week after the Covid outbreak in the Home had been declared over by public health officials.
It said that Dealgan House was the first nursing home inspected during Covid-19 pandemic and the majority of the other Hiqa Inspections were conducted in August and September.
Dealgan House was re-inspected on 8 September and is awaiting the final report, it said.
Commenting on the May report, Director of Dealgan House Eoin Farrelly said:
Dealgan House welcomes the Report’s positive findings which states that “feedback from the Residents and their families was overwhelmingly positive in relation to the care and services provided by staff working in the designated centre”.
“We are particularly happy with the recognition given to our dedicated staff who were under immense pressure at that time.”
The Inspectors Report states that “residents who had contracted the virus and had recovered told the inspectors how well staff had looked after them when they were unwell and that “they could not have done more for me”.
According to the report, “this was also mirrored in the feedback from families who spoke with the inspectors who expressed their “gratitude for all the staff had done” and “for the compassion and support that they had received during this time from the staff”.
The May report highlighted some areas that needed attention and the nursing home attended these issues immediately, so much so, that in the follow up inspection all residential care related regulations were deemed compliant.
We continue to take all possible steps to protect our residents and staff during the current surge. We ask everyone to fully observe the Government restrictions so as to bring this frightening surge under control and protect the elderly in our society.
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