There were 41 dependent persons present on this date. The Nursing Home is currently fully registered for forty two dependent persons.

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1 Nursing Home Inspectorate, HSE Dublin North East Area, Kells Business Park, Cavan Rd., Kells, Co. Meath. Tel No: / Fax No: Friday, 03 August 2007 Ms. Brenda Keyes, Registered Proprietor, St. Colmcille s Nursing Home, Kells, Co. Meath. Inspection Report Re: Inspection of St. Colmcille s Nursing Home, Kells, Co. Meath under the Health (Nursing Homes) Act, 1990 and the Nursing Homes (Care and Welfare) Regulations, Dear Ms. Keyes, The Health Service Executive Nursing Homes Inspection Team from a nursing and environmental health perspective inspected St. Colmcilles Nursing Home, Kells, Co. Meath on 4/5/07 the from 10.45am to 3.50pm and on 12/4/07 respectively. This inspection was routine unannounced. There were 41 dependent persons present on this date. The Nursing Home is currently fully registered for forty two dependent persons. Issues identified in the previous Inspection Report dated 15/01/07 related to s 11.2 (f), 11.2, 19.1 (e) and 27.3 have been addressed satisfactorily. The following issues require your immediate attention and action, relating to recurrent noncompliances: 11.2 (h) and 11.2 (e).

2 11.2(a) In every nursing home there shall be provided suitable and sufficient accommodation which meets the minimum standards as follows:- adequate accommodation and space in single and shared sleeping rooms and portable screens or screening curtains to ensure privacy for individual persons. Non-compliance 1. Screen curtain in twin room numbered ** of insufficient length to ensure privacy to provide adequate privacy between dependent persons when undertaking personal care. 2. There is no separate designated area for hairdressing. All hairdressing activities are currently undertaken in a private resident s room. 1. Take measures to provide curtain of screening of sufficient length to provide dependent persons with privacy when undertaking personal care. 2. Designated facilities for hairdressing, separate from resident s bedrooms shall be provided Within 2 weeks of receipt of this report 11.2(c) In every nursing home there shall be provided suitable and sufficient accommodation which meets the minimum standards as follows:- doorways and corridors which allow for easy use of wheelchairs and walking aids and access ramps where appropriate. Corridor and shower room are cluttered with wheelchairs and equipment, the current equipment store room was completely full on the day of inspection. There is inadequate storage available to store this equipment. Identify and provide further space or a room for storage of equipment

3 11.2(f) In every nursing home there shall be provided suitable and sufficient accommodation which meets the minimum standards as follows:- suitable and sufficient equipment and facilities having regard to the nature and extent of the dependency of the persons maintained in the nursing home. Non-Compliance 1. Equipment schedule indicating service record for three hoists in use, was unavailable to the designated officers on the day of the inspection. 2. There is no chair scales available for weighing dependent persons. On the day of inspection two dependent persons ** and ** were receiving peg feed. ** is unable to co-operate to use the standing scales, there was no recorded weight for this resident since 02/02/ Make available to the designated officers information regarding equipment in use in the nursing home. 2. Provide suitable equipment to weigh dependent persons unable to use standing scales safely. 12 (e) The registered proprietor and the person in charge of the nursing home shall:- ensure that safe floor covering is provided. The floor covering in the corridor outside the assisted shower room across from room ** and in the assisted bathroom on the way to the laundry was dirty, worn and difficult to clean. The floor covering outside room ** was also worn. Provide a new floor covering which is durable, non absorbent, non slip and easy to clean. Within three months of receipt of this report.

4 14 (a) The registered proprietor and the person in charge of the nursing home shall:- ensure that the Nursing Home and its curtilage is maintained in a proper state of repair and in clean and hygienic condition. 1. During the inspection it was observed that mopping of floors was being carried out using dirty wash water. The floor in the private visitor s room required cleaning. In rooms **,**,** and ** and in the assisted shower room across from room ** there was an unpleasant odour present. Dampness was evident in the ceiling around the mechanical ventilation in this shower room also. In the bathroom of room ** there was a small hole in the ceiling. 2. On the day of the inspection the designated officers found the hospital bed frame of patient in room **, with a food substance spilled on the frame, it appeared to be unhygienic and dried into the metal of the framework. The dependent person ** in room ** has peg feeding and designated officers were informed that the feed can sometimes leak. The peg feeding machine did not appear clean. 1. Organise a thorough cleaning of all areas mentioned above. Treat dampness in ceiling of shower room and repaint ceiling as necessary. Repair hole in ceiling in bathroom of room **. 2. The bed frame will require careful daily cleaning, any spillages of enteral food should be cleaned immediately. 1. Within 7 days of receipt of this report 2. Within 7 days of receipt of this report 14 (b) The registered proprietor and the person in charge of the nursing home shall make adequate arrangements for the prevention of infection, infestation, toxic conditions, or spread of infection and infestation at the nursing home. There is no automatic bedpan washer facilities in the sluice room. Provision of a bedpan washer in order to sterilise bedpans and urinals

5 17 The registered proprietor and the person in charge of the nursing home shall have a brochure available with information about the nursing home, including the name and address of the home, the name of the registered proprietor, the admissions policy, accommodation provided and special facilities and services. Include details of the registered proprietor name and admissions policy on the brochure. To have a brochure available with information about the nursing home, including the name and address of the home, the name of the registered proprietor, the admissions policy, accommodation provided and special facilities and services. 29(a) The registered proprietor and the person in charge of the nursing home shall:- make adequate arrangements for the recording, safekeeping, administering and disposal of drugs and medicines. On the day of inspection the designated officers observed Galfer syrup for ** left on the bedside locker of room **. Medication should never be left unattended in the dependent persons room. The person in charge ensures that all staff have read An Bord Altranais Guidelines Guidance to Nurses and Midwives on Medication Management June Ensure all prescribed medication is not left unattended in a dependent persons room. As per verbal feedback given on the day of the inspection within one month of receipt of this report.

6 11.2 In every nursing home there shall be provided suitable and sufficient accommodation which meets the minimum standards as follows:- (h) suitable and sufficient lighting and ventilation, with natural lighting and ventilation in rooms which are regularly occupied by dependant persons Non Compliance There were no functioning bedside lights in rooms *,*,,*, **&**,**,** and **. No bedside lights at all were provided in rooms **, **, ** and **. There was a strong odour of smoke in the smoking room. Check functioning of lights and replace bulbs in rooms *,*,*, **&**, **,** and **. Provide bedside lights in rooms **,**,**,and **. Ensure that the mechanical extract ventilation provided in the smoking room is turned on when the smoking room is in use. Within 7 days of receipt of this report. Recommendation Ensure adequate training and supervision is provided to cleaning staff to ensure that correct cleaning procedures are followed. To ensure a systematic approach to cleaning it is essential that cleaning schedules are devised. These shall include; (i) all surfaces to be cleaned including structures, fittings, furnishings and equipment, (ii) the frequency of cleaning, (iii) materials to be used for cleaning and dilution rates of detergents/disinfectants (iv)the personnel responsible for carrying out the cleaning. It is essential that management check that cleaning schedules are being adhered to. Separate equipment, brushes and cloths shall be used to clean toilet areas. All lights and light fittings to be checked routinely on a weekly basis as part of a general maintenance scheme. The Chairperson of the Inspection Teams to be notified in writing on or before the above dates the steps taken by the nursing home to carry out the actions as required under the regulations. Signed: Chairperson/ Designated Officer. Environmental Health Officer/ Designated Officer. Designated Officer. cc. Ms. Caroline Day, Person in Charge,

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