Flu-deaths care home 'had poor infection controls'
THE nursing home at the centre of a deadly flu outbreak had weak standards of infection control which increased risks to elderly residents, a watchdog report revealed yesterday.
The flu outbreak in the Nazareth House home in Fahan, Buncrana, in Co Donegal, was last month blamed for the deaths of seven frail residents, four of whom died after admission to Letterkenny General Hospital.
Inspectors were called to the home on April 2 to 4 last when HSE public health officials were eventually alerted by a GP after six residents died in less than two weeks.
Their report, published by the Health Information and Quality Authority (HIQA) yesterday, revealed lax controls to reduce infection spread, including insufficient use of hand sanitiser, dirty commodes and bath chairs and a lack of cleaners in the home after 3pm.
It also emerged the home had no system in place to share information about illnesses suffered by different residents, which might have triggered an alert.
On the first day of inspection there were not enough nurses on duty due to holiday and illness and just one of the 65 staff confirmed they had got the flu vaccine. Reacting to the report last night the Sisters of Nazareth, who own the home, insisted it was still not clear if all the deaths were due to the flu outbreak.
The order pointed out that the report said the seven deaths occurred "possibly" due to flu-related illness with four dying in hospital. In a statement the nuns said the average age of the residents who died was 89, and as post mortems were not carried out, flu "as the sole contributory factor" cannot be confirmed.
They had worked with HIQA to remedy weaknesses with infection control and the management of outbreaks has now been revised.
The inspectors found overall the care of the residents was satisfactory and once they became ill they were quickly given medical attention.
However, a range of concerns emerged including:
• Failure to notify HIQA of a case of infectious disease.
• Stained or rusty commodes.
• Temperatures in bedrooms were below the recommended 21 degrees.
• Failure to inform the chief executive of the nursing home about the outbreak until six people had died.
• A lack of contingency arrangements for staff shortfalls and a lack of cover for the absence of the person in charge
• Just 22 of the 65 staff had infection control training.
The inspectors set out a series of actions which needed to be addressed and all of these are now receiving attention, including the hiring of more nursing staff and the extension of hours worked by cleaners.
Responding to inspectors' concerns that "poor arrangements for internet access compromised the ability of outside professionals to obtain and relay information in a timely manner" the owners said it had fully upgraded its IT systems and internal cabling 18 months previously.
But they added Fahan had an "underdeveloped" residential and business broadband service and this would remain.