A poorly coordinated response to an outbreak of scabies at a Kilkenny nursing home led to non-compliance in infection control, according to an inspection report by the Health Information and Quality Authority (HIQA).
The report says that a significant number of residents and staff had shown signs of a contagious skin infestation since September 2024, almost ten months prior to the inspection.
A clinical diagnosis of scabies was made by a GP, and a dermatologist confirmed crusted scabies, which is a severe and more contagious progression of infestation.
The public health team was notified and an outbreak of scabies was declared at the end of May this year.
The report says the response to the outbreak was "fragmented and lacked coordination and oversight", which "likely contributed to the persistence of the issue".
A review of documentation by HIQA indicated that residents showing signs of infestation were not immediately isolated pending clinical diagnosis and for 24 hours after initial treatment.
This, according to the watchdog, may have allowed the infestation to spread between residents, staff and possible visitors.
Two residents had completed their initial course of treatment on the morning of the inspection. However, staff were unclear regarding the required duration of isolation following the initial course of treatment.
The report points out that clothing and bedding were mismanaged after residents received treatment for confirmed or suspected scabies, with unnecessary delays prior to sending for laundering.
Additionally, items that could not be laundered, such as slippers, shoes and soft toys, were not appropriately managed when residents were treated, according to the report.
Bedrooms were also not routinely deep cleaned when residents were treated for the condition.
The provider was required to take urgent action following this inspection to ensure there was local oversight, supervision and assurance mechanisms in place to ensure that the outbreak was effectively managed.
The inspection report is one of 50 published today.
Evidence of good practice and compliance with regulations and standards were found in a number of inspections.
However, 19 centres were non-compliant with three regulations or less, and seven centres non-compliant with four or more regulations.
In a South County Dublin nursing home, the registered provider failed to take all reasonable measures to protect residents from all forms of abuse.
Some had a history of responsive behaviours, which were a known safeguarding risk to other residents and had measures documented to mitigate risk.
However, the measures had not always been effective and had failed to protect residents from abuse, according to the report.
When inspectors visited the home in June, multiple residents, visitors and staff reported that the temperature in the centre, including some bedrooms and communal areas, was excessively warm.
This was a significant issue during the inspection, according to HIQA.
The inspectors were informed that the central heating could not be switched off, nor could the settings be adjusted to account for the outdoor temperature.
A number of instances where residents were not adequately supervised were also observed.
A resident who had been assessed as being at high risk of falls was seen standing on a chair with no staff present.
Three residents in the sitting room were also seen sitting for 20 minutes without staff supervision and without access to a call-bell for assistance if required.
