The management of a severe Covid-19 outbreak at a Co Clare nursing home during the third wave of the pandemic was “chaotic and disorganised”, the State’s health service regulator has said.
The Health Information and Quality Authority (Hiqa) found during an unannounced inspection in January that Cahercalla Community Hospital in Ennis – home to 89 residents – had no person in charge during an outbreak that infected 23 residents and 23 staff.
In its report, the authority said three residents died during the outbreak.
Inspectors carried out a “risk inspection” over three days at the home in response to the outbreak, which noted the absence of a person in charge, delays in updating the Covid-19 status of residents, and delays in submitting notifications of unexpected deaths of residents.
Hiqa said the nursing home, overseen by a board consisting of five volunteers and a company secretary, had not had a general manager in place since November and failed to ensure someone “with the requisite experience in nursing older persons” was in charge.
It said there was an “inadequate” management system in place at the care facility that affected the ability to recognise, respond to and contain the outbreak. The regulator noted an absence of accurate information about the number of staff available to work from one shift to the next.
The home was found to be non-compliant on all 12 regulations against which it was inspected, including in the areas of staffing, healthcare, residents’ rights and infection control.
Inspectors observed “significant gaps” in staff knowledge of infection prevention and control measures and the identification of typical and atypical Covid-19 symptoms, which “posed a significant risk to the wellbeing of residents” during the outbreak and to the staff.
Communal areas
On one unit of the nursing home, inspectors observed staff without masks on dinner breaks in communal areas for residents and in the company of residents, according to the 39-page report.
Hiqa issued a written warning to the home on January 25th advising the provider of their legal obligations “to put in place governance and management arrangements and to ensure effective oversight of the care and welfare of residents and supervision of staff providing the care”.
The findings were contained in one of 34 inspections reports published by the regulator on Friday. Evidence of non-compliance with regulations was found in 25 homes.
Infection prevention
A report on Sacred Heart Residence in Raheny, Dublin, run by Little Sisters of the Poor, said that almost half of the 78 residents were infected in a Covid-19 outbreak last April as well as 71 staff. Seven residents died. Poor infection prevention and control practices, including the failure to separate staff into groups to prevent the spread of Covid-19, were identified.
An inspection report on the HSE-run Clonskeagh Community Nursing Unit in Dublin said that 60 staff and 49 residents contracted Covid-19 in an outbreak that lasted from March to August 2020. Fifteen residents died at the home, which was found to be compliant in all but three of 13 regulations checked.
