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Oakwood Residential Home Good

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Inspection report

Date of Inspection: 23, 24 January 2014
Date of Publication: 12 March 2014
Inspection Report published 12 March 2014 PDF

People should be cared for in a clean environment and protected from the risk of infection (outcome 8)

Enforcement action taken

We checked that people who use this service

  • Providers of services comply with the requirements of regulation 12, with regard to the Code of Practice for health and adult social care on the prevention and control of infections and related guidance.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 23 January 2014 and 24 January 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We also spoke with external healthcare professionals.

Our judgement

People were not protected from the risk of infection because appropriate guidance had not been followed. People were not cared for in a clean, hygienic environment.

Reasons for our judgement

At our last inspection on 11, 16 and 19 September 2013, we found the provider was failing to meet this essential standard. Procedures for infection control were not robust and staff practices put people at risk of cross infection. Appropriate guidance was not followed and people were not always cared for in a clean, hygienic environment.

Following the inspection we took enforcement action and imposed a condition to prevent the provider from accepting any new admissions to the home.

At this inspection we found staff had received refresher training in infection control. Some beds had been replaced and a wet room had been refurbished to provide a suitable shower facility.

We looked at the provider’s policies and procedures relating to infection control. We saw these had been reviewed since our last inspection and were up to date. Infection control risk assessments, for most areas of the home, had been completed, together with an annual statement of infection control and an audit.

However, we found the audit was not comprehensive; it did not examine the arrangements for waste disposal, the effectiveness of cleaning, the availability of equipment for hand washing or the effectiveness of infection control risk assessments.

Providers are required to have regard to the Department of Health’s ‘Code of Practice on the prevention and control of infections and related guidance’. The Code of Practice sets out the basic steps to ensure compliance with the infection control requirements of the Health and Social Care Act, 2008. The provider had not taken the steps necessary to meet the requirements of this standard.

We found the home’s policies were not being followed by staff. For example, the policy required staff to wash their hands before and after delivering personal care and to wear disposable aprons and gloves when there was a risk of contact with body fluids. We found this was not always possible.

Staff told us the wet room was frequently used to deliver personal care such as changing people’s incontinence pads. We saw the room contained no disposable aprons or gloves to protect staff and no soap or hand towels to enable them to wash their hands before or after changing pads.

Staff told us disposable aprons and gloves were available elsewhere in the home. However, the lack of readily available personal protective equipment (PPE) in places frequently used to deliver personal care meant staff may not be able to access protective equipment when they required it.

We looked at the ‘sluice room’, which staff told us was used to clean commode pots. This room contained disposable hand towels but no soap. We spoke with three members of staff, who told us they used the sink in the staff toilet to wash their hands after using the wet room and the sluice room. However, to access this toilet staff needed to pass through other areas of the home. This posed a risk that microorganisms could be transferred to these areas en route.

Care practices put people at risk of cross infection. In the wet room, the sluice room and the ground floor bathroom, there were bins for disposing of clinical waste. The bins did not have lids. We saw used incontinence pads and used PPE inside the bins, which were exposed and readily accessible to people using the service. People were not protected from the risk of cross infection from these items as waste disposal arrangements were not adequate.

We spoke with three members of staff about arrangements for emptying and cleaning commode pots. Each described a different method for processing used commode pots. One member of staff told us they used an upstairs bathroom, which we found was locked and not in use; another member of staff told us they emptied the pots in the toilet in the wet room and took them through the lounge to the sluice room for cleaning; and a third member of staff told us they used the sluice room to empty and clean the pots. There were no procedures in place to ensure staff followed appropria