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

There was a lack of meaningful activities available for residents in the centre, which meant that, for the most part, residents were not participating in activities of interest to them. For example:  "Many residents were seen to be sleeping in chairs or sitting in front of the TV with little stimulation and engagement, throughout the days of inspection."

Inspectors were not assured that residents could exercise choice in relation to their preferred routines. The majority of residents were in bed when inspectors arrived at the centre around 10am. Residents were seen asking for support for assistance to the toilet or going to bed, and there were insufficient staff to support them at the time of the request.

“This inspection found a marked decline in the level of regulatory compliance for this centre. Significant improvements were required in the oversight and management of the service to ensure safe effective systems were in place to support and facilitate the residents to have a good quality of life,” the report stated.

The provider, responding to the HIQA report, acknowledged the staffing deficits identified during the inspection. 

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While full staffing levels have not yet been achieved, significant actions were underway to ensure that the centre would have the appropriate number and skill mix of staff to meet residents’ assessed needs and the layout of the centre. 

Residents who experienced delays in receiving showers or toileting assistance have been followed up with. Staff have been reminded to communicate clearly with residents if delays occur and to support residents as soon as possible. The Person In Charge (PIC) at the home has increased morning oversight to ensure personal care routines are completed in line with residents' preferences.

The call-bell system has been approved for a full upgrade.

The registered provider representative will continue to monitor staffing, care delivery and response times to ensure sustained progress toward full compliance.

Improper medication storage, administration and stock-control practices observed during inspection have been addressed with the nursing team, and additional medicines management oversight is being provided by the PIC.

Remedial works are planned to ensure consistent and appropriate ambient temperatures throughout the centre. 

Room disinfection processes have been revised to ensure that rooms are cleaned thoroughly prior to the application of disinfectant. Deep cleaning schedules have now been developed and implemented.

All inappropriate storage of medication was immediately rectified. Staff have been reminded that medications and supplements must never be left in communal or unsecured areas. 

The full HIQA report and full response from the care provider at Brookhaven Nursing Home can be read on the HIQA website.