Vulnerable adults suffered repeated outbreaks of skin infections in a Co Tipperary nursing home where bed linen and mattresses were so worn they could not be cleaned properly and there were too few staff to clean the premises adequately, an inspection has found.
Following its unannounced inspection on November 27th the Health Information and Quality Authority (Hiqa) found St Teresa’s Home in Cashel was non-complaint with nine of the 10 standards it examined. Noncompliance was found in areas of staffing, governance and management, infection control, fire precautions and residents’ rights.
Located in Cashel in a former 19th century convent, the Cashel Care Ltd-managed centre opened in 2003, catering for up to 30 male and female residents. On the date of inspection there were 24 people living there, in single and twin bedrooms.
Hiqa inspectors saw “kind interactions between staff and residents” during which staff greeted residents by name “and were seen laughing and singing with” them.
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However, Cashel Care could not ensure the service was “safe, appropriate, consistent and effectively monitored”.
Four residents had been treated for a contagious skin condition the previous month, the inspection report states.
“A previous outbreak of the same condition had occurred in November 2023. Inspectors were concerned that the same two bedrooms were impacted for both outbreaks.”
Inspectors found pillows, duvets and a small number of mattress that were torn and could not be effectively cleaned. On reviewing rosters, there was a reduction in staff assigned for cleaning duty, the report states.
There were “limited clinical hand hygiene facilities available for staff”, it notes.
Inspectors issued an “immediate action ... to have soiled toilet seats cleaned in two resident communal toilets”, the report states.
The cleaning checklist reviewed indicated these toilets were cleaned once a day, which “was not sufficient to ensure good hygiene standards”.
“Overall significant improvements were required to meet the assessed needs of the residents and to promote their rights,” it adds.
An immediate action was issued to ensure residents’ records were securely stored as these were found “in an unlocked cabinet in the corner of the dining area”.
In terms of residents’ privacy and dignity, inspectors found there was “inadequate space” for residents to store their personal belongings. Light switches for residents’ bedrooms were located on the wall outside in the corridor and there was insufficient space for them to carry out activities in private around their bed-space, the report states.
In the diningroom, residents had to ask for condiments as they were not placed on the table.
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“Meals came to the table with sauce already poured on the food, which removed the residents’ choice about how to have their meal.”
Concerns were noted about staffing levels, fire safety and whether rooms were adequately heated or ventilated.
Included as an appendix to the report is Cashel Care’s action plan to address Hiqa’s concerns.
