A HIQA report has found that the there were some deficits in the standard of cleanliness and hygiene at Nazareth House in Fahan.
The report also found that there appeared to be no established procedure to enable early detection of influenza in the nursing home.
The two inspections carried out by the Authority on 2, 3 and 4 April 2012 were triggered by a report of a significant number of resident deaths in the centre during March and April.
Nine residents died during the period 22 March to 8th April.
Seven of these deaths are currently classified as possibly consequent to an influenza related illness.
The purpose of the inspection last month was to gather evidence on which to make judgments about the fitness of the registered provider and to report on the quality of the service.
On day-two of the inspection there were 38 residents in the centre. One resident was in hospital.
The report found that robust communication procedures were not in place. Senior management was not communicated with in a timely manner and there was a lack of clarity and accountability about how information on the outbreak had been reported.
There was a lack of coordination of the information available where residents were diagnosed with a respiratory illness and were being cared for in the designated centre or in hospital. There was no system to alert professionals to the possibility of an influenza outbreak which created additional risk.
It also found that while the Person in Charge was off duty due to medical advice from the public health team there was no designated person in charge.
The report found there were deficits in aspects of infection prevention and practice and areas where supervision was required. Some areas did not have appropriate accessible supplies of products such as hand gels to assist in good infection control management and some equipment and areas of the premises were not in a satisfactorily clean condition.
A number of polices were not comprehensive and did not provide sufficient guidance for staff. This included the infection control procedure and the emergency plan which required revision to include the arrangements in place to address an outbreak of infectious illness, the contingency measures to address staff shortfalls and the management of communication during a critical event.
The report found there was insufficient staff or skill mix to meet the assessed needs of residents taking into account the declared dependency levels, clinical monitoring requirements, changing needs, the number of residents accommodated and the size and layout of the centre.