The Health Information and Quality Authority has said a community hospital owned and operated by the Health Service Executive did not adhere to Health Protection Surveillance Centre guidelines during Covid-19 in April.
An inspection report by HIQA said residents at the Clonakilty Community Hospital in Cork suspected of being infected by the Covid-19 virus or who tested positive for the virus, or were known contacts of residents that tested positive for the virus, were not isolated or quarantined.
The centre had a significant outbreak of Covid-19 in April and May and a large number of residents and staff tested positive for the virus.
An unannounced risk-based HIQA inspection in June found there were improvements in local governance and management arrangements.
The centre's registration was previously renewed in April 2016 and since then, HIQA said there have been six inspections of the centre.
HIQA said all of the inspections found that Clonakilty Community Hospital had significant levels of non-compliance in relation to overall governance and management.
It said proposed conditions required a reduction in the number of residents accommodated in some identified multi-occupancy bedrooms and the creation of additional communal space in the form of a new sitting room.
HIQA said that during the Covid-19 outbreak, a significant number of staff were impacted by the virus and there was an aligned increase in the care residents required.
As a result of staff absenteeism, it said there were insufficient numbers and skill-mix of staff to safely care for residents.
In response, the HIQA report said the HSE had to redeploy staff from other areas, such as day care services, to maintain the staffing levels to care for residents.
HIQA said that through frequent communications by the inspector with the management of the centre, it was evident that the HSE was not adhering to and implementing the HPSC national guidelines with respect to the isolation and quarantining of residents.
It said these identified risks to residents and staff were escalated to the HSE at a national level in April.
The HSE responded explaining that as a consequence of the limitations of the physical premises, residents who tested positive for the virus remained in shared bedrooms with residents that may have previously tested negative for the virus or were not showing symptoms of the virus.
The report said there are only a small number of single rooms and these were not always available when it became necessary to isolate residents.
At the latter stages of the outbreak, the transitional care unit, which is used for short-stay residents, was used to isolate residents.
It noted that this unit had become vacant as short stay residents were not admitted during the outbreak.
HIQA said improvement and focus is now required to ensure the governance and management arrangements in place always provides a safe quality service to residents and that the nursing home comes into regulatory compliance.
Clonakilty Community Hospital comprises of two buildings which date back to the 1800s.
Resident accommodation is spread across five units in the centre and is registered to provide long term, respite, transitional care, palliative and dementia care for 122 residents.
On the days of the inspection the number of residents living in the centre had reduced from 122 to 77.
The reduction in the numbers was as a result of a decision not to admit any new residents during the Covid-19 outbreak.
The report is one of 34 published by HIQA today on nursing homes.
