A “skin infestation” outbreak at a Kilkenny nursing home was not managed appropriately, risking the spread of the disease to residents, staff and the public, an independent inspection has found.
On Thursday, the Health Information and Quality Authority (Hiqa) published 50 inspection reports on residential centres for older people.
Of those, a total of 22 centres were either fully compliant or substantially compliant with the regulations. In general, these centres were found to be meeting residents’ needs and delivering care in line with the national standards and regulations, Hiqa said.
However, the regulator highlighted concerns in a number of premises, including Kilkenny Care Centre, run by Mowlam Healthcare services.
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The unannounced inspection in July identified how a significant number of residents and staff had shown signs of a contagious skin infestation since September 2024.
A clinical diagnosis of scabies was made by the GP, and a dermatologist review of one case confirmed crusted scabies, which is a severe and more contagious progression of scabies infestation.
An outbreak of scabies was declared by public health officials on May 29th, but the inspectors raised concern that “only one outbreak control meeting had taken place to date”.
“The response to the scabies outbreak to date had been fragmented and lacked co-ordination and oversight, which likely contributed to the persistence of the issue,” the inspection report said.
“A review of cleaning records showed that bedrooms had not been deep cleaned after residents received treatment for confirmed or suspected scabies. This may result in re-infestation and ongoing transmission within the centre.”
The inspectors also highlighted how residents showing signs of infestations were “not immediately isolated pending clinical diagnosis and for 24 hours after initial treatment”.
“This may have allowed the infestation to spread between residents, staff and possible visitors,” it added.
According to the report, scabies treatments were not properly applied or administered as per public health recommendations.
This raised concerns as incomplete or ineffective treatment allows “infestation to persist and spread”.
Furthermore, Hiqa said clothing and bedding were “mismanaged” after residents received treatment for confirmed or suspected scabies, with unnecessary delays before sending for laundering.
The facility had 88 residents at the time of inspection, which was carried out following “deficits in the provision of care” being identified at its previous inspection on February 19th, particularly in relation to safeguarding.
A number of safeguarding incidents had been notified to the chief inspector since the previous inspection, some of which related to physical interactions between residents, while others related to alleged neglect of residents by staff.
The inspectors found safeguarding plans had been put in place in response to these incidents.
Following the inspection, the provider submitted a compliance plan to Hiqa in which it said it would improve infection prevention and control by improving the isolation of patients, introducing a scabies care plan for each resident and beginning regular meetings in relation to the issue.
