HIQA finds hand hygiene issues during Covid outbreak in nursing home

 

The Health Watchdog has raised concern over hand hygiene and housekeeping practices at an east Donegal nursing home.

Brindley Manor Nursing home in Convoy is a purpose built single storey residential care facility that can accommodate 43 residents who need long-term, respite, convalescent and end-of-life care.

The unannounced risk inspection took place on October 13th 2020 in response to what’s been described as significant Covid-19 outbreak at the facility that was notified to the Chief Inspector on 29th September and a concern received in relation to infection control practices in the designated centre.

On the day of the inspection the centre had an outbreak of Covid 19 affecting 11 staff and 30 residents.

The residents were cohorted into two distinct areas with residents who had Covid -19 detected accommodated in two units and those residents for whom Covid-19 had not been detected were cared for on one unit.

The outbreak was triggered when five staff had Covid-19 detected on the serial testing of staff in the designated centre.

During the outbreak 33 out of 41 residents and 17 staff out of a complement of 42 contracted the virus. There were two deaths in the centre associated with the outbreak.

At the time of inspection the public health team and an infection prevention and control nursing expert were providing advice and guidance in relation to the management of the outbreak at the centre.

The centre had a good history of compliance with the regulations and there was a clear management structure in place which consisted of the person in charge, assistant director of nursing and the group operations and compliance manager.

The Chief Operating Officer was also present on site on the day of the inspection and he represented the registered provider who was not available.

However on the day of the inspection the assistant director of nursing and the operations/compliance manager were both working on the floor as the nurses in charge of the two cohorted units.

Inspectors found that the person in charge was the only senior person rostered to work in a supernumerary capacity and available to support and supervise staff during a significant Covid-19 outbreak.

As a result inspectors found that staff did not have access to appropriate support and supervision in their work on the day of the inspection and a number of breaches in infection prevention and control practices were not identified and addressed.

In addition inspectors found that the oversight of key areas such as staff training, risk management, infection control processes and housekeeping and maintenance was not sufficiently robust.

There were sufficient staff on duty to meet the needs of the residents however inspectors found that staff practices in hand hygiene and housekeeping required further review and improvements to ensure that national best practice guidance was followed (Health Protection Surveillance Centre Interim Public Health, Infection Prevention and Control Guidelines on the Prevention and Management of COVID-19 Cases and Outbreaks in Residential Care Facilities guidance).

In response to the inspection, the registered provider said that they would ensure that procedures, consistent with the standards for the prevention and control of healthcare associated infections published by the Authority are implemented by staff.

The link to the full report can be found here:

https://www.hiqa.ie/system/files?file=inspectionreports/323-brindley-manor-private-nursing-home-13-october-2020.pdf