Scabies outbreak and 'smell of urine' discovered by HIQA at Kilkenny care home

 A Kilkenny nursing home had a scabies outbreak and a “strong smell of urine” on both days of a two-day  HIQA inspection, it has been revealed.

The HIQA inspectors concluded that residents at the home “did not receive a good standard of care” having discovered that the home was ‘non compliant’ in 12 of the 13 inspection categories, including infection control, pharmaceutical services and staffing, 

Management at the home were issued with an urgent compliance plan, followed by a second a number of days later when this was not adequately addressed, and a ‘warning meeting’ was held with the care provider.

Steps have been taken to address the issues raised.

The unannounced inspection took place at Brookhaven Nursing Home, in Ballyragget,  last September. The HIQA report was released today, January 13, 2026.

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Brookhaven provides full-time nursing care for people with low to maximum dependency assessed needs requiring long-term residential, palliative, convalescence and respite care and on the day of the first inspection there were 67 residents.

The HIQA report makes stark reading and lists many issues discovered in the inspection, held “to follow up unsolicited and solicited information received by the Chief Inspector, pertaining to serious incidents notified, safeguarding, residents' rights, the quality of care, including health care provided to residents living in the centre.”

HIQA said the information “was substantiated on this inspection.”

Speaking to the inspectors, “residents and visitors expressed concerns relating to the centre being short-staffed.” They said “the centre was cold, in particular some bedrooms and communal areas. 

“A number of residents told the inspectors that there was a shortage of bed sheets and that sometimes blankets or duvet covers were used to cover the mattress as a substitute for sheets.”

Concerns detailed in the comprehensive HIQA report include:

• “A strong smell of urine was detected in parts of the centre on both days of inspection.
•  “There were three sluice rooms for the reprocessing of bedpans, urinals and commodes. On the morning of the second day of inspection there were no bedpan washers working in the centre. By the end of the second day there was one bedpan washer working in the centre.

“The shortage of staff was observed to adversely impact residents in the centre leading to delays in care and residents' not being provided with care in line with their preferences and assessed needs.

• “Inspectors observed a resident who had to wait over 15 minutes to be assisted to the bathroom, despite the call-bell being activated by staff to gain support.  
• “One resident told the inspectors that the staff informed her they were short staffed on the morning of the second inspection and would not have time to give her a shower that morning but would return later at 3pm. The resident confirmed with the inspectors that the staff never returned to give them a shower at 3pm.”

Inspectors said audit systems at the home were ineffective at identifying risks and driving quality improvements. For example: 

• “A medication management audit carried out in June 2025 evidenced 42% compliance. An action plan had been developed on paper, however, three months later, the findings of this inspection showed no improvement in any of the identified areas."

The report goes on to say that “an ongoing scabies outbreak in the centre was likely exacerbated by several infection prevention and control failures, including the lack of resident isolation when symptomatic, unclear guidance for staff, improper management of laundry and non-washable items as well as potential errors in the application and administration of treatments. 

“These gaps contributed to continued transmission and highlight the need for enhanced staff training, standardised procedures and improved oversight of infection prevention and control procedures. 

“Not all staff had access to appropriate training to support them to perform their respective roles.

“The management systems in the centre were inadequate and not effective at ensuring the service provided was safe, appropriate, consistent, and effectively monitored. 

“The registered provider did not ensure the premises of the designated centre were appropriate to the needs of the residents and in line with the statement of purpose. For example: 

• “Staff were observed to utilise resident communal spaces for meal breaks, despite a staff break facility being available.”

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Other concerns highlighted by HIQA included:

• “Parts of the centre required repair to ensure they could be effectively cleaned. For example: floors in the staff room, smoking room and bedroom areas were damaged.  
• “There was no system for adjusting or recording the temperature in the centre. Areas of the centre were cold, and the residents and visitors told inspectors that this was a long standing issue and was reported by residents and visitors.
• “Residents were observed to be smoking in non-designated smoking areas, such as doorways and as a result there was a strong smell of cigarette smoke in a number of corridors. 

Inspectors noted that “the provider did not meet the regulatory requirements and the National Standards for infection prevention and control in community services (2018). For example:

• “In the absence of a hand wash basin in the housekeeping room, there was a lack of assurance that housekeeping staff performed hand hygiene at the point of use.  
• “Clinical waste bins in the centre were not enclosed and pedal operated for the the safe disposal of potentially contaminated items, such as used PPE and wound dressings
• “Inspectors observed poor hand hygiene practices.”

Practices observed in relation to the storage and use of some medications were not in line with best-practice medicines guidance. 

“Medications were stored inappropriately in an unsafe manner. For example, prescribed topical medication was found in residents bathroom with the lid open and food supplements were found in unlocked press in communal area. Medication for use in the treatment of scabies was not always administered in line with prescriber's directions  There were inaccurate records for the administration of prescribed medication i.e. eye drops and the medication used for the treatment of scabies.  Nurses were not adhering to best practice procedures when counting control drug medications. Click the NEXT arrows to continue reading from the HIQA report and the response from the care provider...