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Rumble in the Jungle
– Maverley-Hughenden vs UWI Time: 3:30 p.m. Venue: Constant Spring Complex – Jamalco vs Waterhouse Time: 3:30 p.m. Venue: Wembley Centre of Excellence in Clarendon – Tivoli Gardens vs Portmore United Time: 3:30 p.m. Venue: Edward Seaga Complex – Arnett Gardens vs Humble Lion Time: 6 p.m. Venue: Anthony Spaulding Complex With this scenario in mind, a big ‘Rumble in the Jungle’ is expected, and spectators should brace for end-to-end stuff from the teams. Coach of Humble Lion, Donovan Duckie, says despite his team having beaten the Junglists twice already this season, he anticipates a tough encounter. “We asked the team to be consistent, as what we want to do is keep the momentum going. We know that the team has class and good support. We have been unbeaten in the last six games, so the aim is to go there and leave with a positive result,” Duckie told The Gleaner yesterday. “The guys have been working hard, and we know that it is always difficult to play Arnett in the Jungle. We beat them twice, but know they won’t play dead tomorrow (Wednesday),” he added. Meanwhile, Arnett’s veteran coach Jerome ‘Jerry’ Waite says his team is ready to face the Lions inside the Jungle. “The team is in good stead and ready for a tough challenge against Humble Lion. We are finding the right chemistry, and confident for a win playing at home,” Waite said. Humble Lion will face Arnett Gardens in a highly anticipated clash in the Red Stripe Premier League (RSPL) at the Anthony Spaulding Complex in Trench Town, St Andrew, today, starting at 6 p.m. Humble Lion are currently in second position on 45 points in the 12-team RSPL, a point adrift of leaders the University of the West Indies (UWI), who are on 46, while Arnett Gardens are in sixth position on 35 points. With the top six qualifying for the championship battle at the completion of the third and final preliminary round, both teams will be looking for maximum points. However, Humble Lion are in an automatic semi-final qualification position and will seek full points in order to step closer to a last-four play-off spot. Teams MP W D L GF GA GD Pts UWI 24 14 4 6 33 22 11 46 Humble Lion 24 13 6 5 30 15 15 45 MBU 23 13 6 27 17 10 43 Tivoli 23 13 3 7 33 19 14 42 Portmore 24 11 8 5 25 20 5 41 Arnett 24 10 5 9 32 30 2 35 Reno 24 7 7 0 20 24 -4 28 H. View 24 7 6 11 21 30 -9 27 Waterhouse 24 6 5 12 19 23 -4 24 Mav.-Hugh. 24 4 11 9 20 6 -6 23 Jamalco 24 7 2 15 22 33 -11 23 Boys’ Town 24 5 4 15 22 45 -23 19 TOUGH ENCOUNTER Today’s games – Reno FC vs Harbour View Time: 3:30 p.m. Venue: STETHS Complex Tomorrow’s game RSPL standings
Berbice Expo showcases local businesses
The 14th Berbice Expo and Trade Fair was declared opened at the Albion Sports Complex on Friday evening. The four-day event, which is being promoted by the Central Corentyne Chamber of Commerce, ends on Monday and has more than 100 exhibits. ‘Advancing Economic Progress through Professional Standards and Entrepreneurship’ is the theme for this year’s Expo which has as its objective, the enhancement of economic growth for Berbice.Business Minister Dominic Gaskin, in declaring the Expo open, said over the next 15 years, Guyana’s economic transformation will be guided by the Green State Development Strategy, which will be the blueprint for inclusive economic and social growth.A key objective of the Green State Development Strategy is to reorient and diversify Guyana’s economy, reducing reliance on traditional sectors and opening up new sustainable income and investment opportunities.He added that as Guyana develops, and new economic activities emerge, businesses must adapt to a new economic reality.“Local businesses must build capacity to be competitive in an environment that will see increased competition from both local and foreign companies. This requires emphasis on improvement of business processes, adoption of industry best practices, transparency and accountability, and socially and environmentally responsible behaviour, among others.”Gaskin said the petroleum sector will drive rapid growth while the Green State Development Strategy will channel this growth across all sectors of Guyana’s economy. Businesses must therefore position itself to maximise opportunities that will arise, not only from direct participation in the petroleum sector, but from spinoff demand in many other sectors that will follow.Meanwhile, President of the Central Corentyne Chamber of Commerce, Poonai Bhigroog, also speaking at the opening, noted that more respect needs to be given to the region’s farmers.Noting that Region Six (East Berbice-Corentyne) is an agriculture-based region, Poonai said there is need to raise standards in how agriculture is practiced so that farmers can make maximum use of technology to improve and increase productivity.The Chamber President added that with the closure of several sugar estates, the ripple effects are far and wide. He said the fishing industry continues to be a high risk one as a result of many acts of piracy committed over the years; retail business, market vendors and other sectors are seeing a decline in sales causing several businesses to either close their doors or reduce staffing.“As Guyana becomes an emerging oil and gas producer, several measures will have to be put in place to safeguard and develop new business strategies to preserve our local businesses. Opportunities will abound, but to capitalise on these opportunities, businesses will have to focus on capacity building and improve on developing our work force to reach higher standards. Entrepreneurs will have to start to invest with confidence in our country’s growing economy, more jobs will be created, and disposable income will increase,” the Chamber President said.
C.V. can’t stop Lancers
THOUSAND OAKS – Katie Coulas unleashed a shot in the 50th minute, striking Richelle Mascaro at point-blank range, knocking the wind out of the Crescenta Valley of La Crescenta sweeper and forcing her to double over in pain. It was a brave move on Mascaro’s behalf, sacrificing her body in an attempt to give the Falcons’ girls’ soccer team a spark against Thousand Oaks. Unfortunately for C.V., the wind had already been taken out of its Southern Section Div. II playoff run earlier in the match. Michelle Cruz took advantage of a pass from Coulas that bounced over Mascaro in the seventh minute to score on a breakaway, and sister Nicole Cruz added a goal in the 62nd minute to lead the host Lancers to a 2-0 second-round victory over the Falcons (15-6-3). “We knew we were coming to play against a really good team,” C.V. coach Cesar Hidalgo said. “I know I have a really good team and I feel confident in saying that we can play with anyone. But mistakes like that take you out of the game.” Thousand Oaks (20-4-3) increased its unbeaten streak to 15 in a row entering Thursday’s quarterfinal match at 6 p.m. at rival Westlake (12-2-8). “It’s a good sign when they win 2-0 and they didn’t think they played their best soccer,” said Lancers coach Geoff Raives, whose team is winless in its past seven meetings with Westlake. “They’re looking to be perfect, which is good.” C.V. senior goalkeeper Emma Dearman was the cause of some of Thousand Oaks’ frustration, stopping nine shots. But the Falcons couldn’t clear Rachel Morris’ corner kick out of harm’s way, and after Michelle Cruz and Mary Madden knocked the ball around during a mad scramble in the penalty box, Nicole Cruz tapped a shot inside the right post. “Although we did play well, we all feel like we can do better,” Nicole Cruz said. “We know how to do it because we’ve done it before. We just have to believe in ourselves.” firstname.lastname@example.org (818) 713-3607 160Want local news?Sign up for the Localist and stay informed Something went wrong. Please try again.subscribeCongratulations! You’re all set!
Dunfanaghy man released on bail following Australian crash
He was released on continuing bail for his case appear at local court, Downing Centre, Sydney on October 10th but he waas excused from attending on that occasion.His bail terms include: surrender of his passport and he is not allowed to apply for another, sign on daily at a local police station. Refrain from consuming alcohol or un-prescribed drugs and observe a curfew to remain at a fixed address between the hours of 9.00pm and 5.00am daily.Dunfanaghy man released on bail following Australian crash was last modified: August 29th, 2019 by StephenShare this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to share on Pocket (Opens in new window)Click to share on Telegram (Opens in new window)Click to share on WhatsApp (Opens in new window)Click to share on Skype (Opens in new window)Click to print (Opens in new window) Tags:AustraliacrashdonegalDunfanaghyTerence Wilkinson A Dunfanaghy man who was listed to appear before a court in Sydney Australia on August 15th in relation to a serious road traffic collision has had his case adjourned until October 10th.The Tirconail Tribune reports that Terence Wilkinson was arrested on board a flight destined for Ireland a number of days after it is alleged he was the driver of a car involved in a serious road traffic collision in a suburb of Sydney on July 27th. He is charged with not give particulars in relation to damage of property, two counts of bodily harm by misconduct, in charge of a vehicle, dangerous and negligent driving causing grievous bodily harm.He was also charged with two counts of failing to stop and assist after impact causing injury and one charge of failing to stop and assist after vehicle impact.
MAJOR DRILL FOR EMERGENCY SERVICES ACROSS DONEGAL TODAY
A major drill involving many of Donegal’s emergency services will take place today.The drill, which takes place at Dunree in Inishowen, involves members of Donegal Mountain Rescue Team, the Coast Guard, the RNLI, Gardai, Civil Defence and the Sligo S61 coast guard helicopter.The exercise simulation is a fishing vessel with 22 crew that has sunk who require assistance and a missing helicopter crew of four including a news crew who were covering the rescue. The purpose of the drill is to enhance Search and Rescue and Communications across the Agencies by conducting a major rescue scenario.MAJOR DRILL FOR EMERGENCY SERVICES ACROSS DONEGAL TODAY was last modified: March 24th, 2012 by StephenShare this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to share on Pocket (Opens in new window)Click to share on Telegram (Opens in new window)Click to share on WhatsApp (Opens in new window)Click to share on Skype (Opens in new window)Click to print (Opens in new window) Tags:coast guardDMRTdrillDunreeRNLI
HEALTH AUTHORITY CRITICISES HYGIENE AT FLU DEATH NURSING HOME
STANDARDS of hygiene at the Nazareth House nursing home in Fahan were criticised in a top level report today.The Health Information & Quality Authority (HIQA) also criticised warning systems at the home where seven people died from a flu outbreak in March and April this year.Procedures for dealing with such an outbreak were poor, said the report. The report also criticised how the home dealt with the crisis, noting: “There were insufficient nurses on duty to address the increased workload particularly queries from families and the additional care required by residents who were ill.“The person in charge could not carry out her role fully, as she could not be on duty in the residential area which increased the workload for the nursing staff. Furthermore, two nurses were unavailable to undertake additional work due to holiday and illness leave.”On cleanliness at the home, the report said: “The inspectors found deficits in the overall standard of cleanliness that impacted on good infection control management.“For example some commodes and bath chairs had not been cleaned effectively and were stained or damaged by rust. There was dust on the floor in some bedrooms. There was inappropriate storage of items such as, a hair brush and vases in the sluice. Shower tray outlets were also noted to be unclean and there was no system in place for the regular cleaning or limescale removal from shower heads.” And on how the home reported the outbreak, HIQA reported: “A number of residents had respiratory-type illness and there were clear indicators that there was an outbreak of an infectious illness. Notification was not submitted to the Chief Inspector in a timely manner as required by the regulations.”YOU CAN READ THE REPORT IN FULL BELOW:About the inspectionThe purpose of inspection is to gather evidence on which to make judgments about the fitness of the registered provider and to report on the quality of the service. This is to ensure that providers are complying with the requirements and conditions of their registration and meet the Standards, that they have systems in place to both safeguard the welfare of service users and to provide information and evidence of good and poor practice.In assessing the overall quality of the service provided, inspectors examine how well the provider has met the requirements of the Health Act 2007, the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 and the National Quality Standards for Residential Care Settings for Older People in Ireland. Additional inspections take place under the following circumstances: to follow up on specific matters arising from a previous inspection to ensure that the action required of the provider has been taken following a change in circumstances; for example, following a notification to the Health Information and Quality Authority’s Social Services Inspectorate that a provider has appointed a new person in charge arising from a number of events including information received in relation to a concern/complaint or notification to the SSI of a significant event affecting the safety or well-being of residents to randomly “spot check” the service. All inspections can be announced or unannounced, depending on the reason for theinspection and may take place at any time of day or night.All inspection reports produced by the Health Information and Quality Authority will be published. However, in cases where legal or enforcement activity may arise from the findings of an inspection, the publication of a report will be delayed until that activity is resolved. The reason for this is that the publication of a report may prejudice any proceedings by putting evidence into the public domain.2About the centreDescription of services and premisesNazareth House is a single-storey building which was built as a nursing home in 1981. It is owned and operated by the Sisters of Nazareth Religious Congregation. The centre is registered to provide care for 48 male and female residents who have long-term palliative or convalescent care needs. Respite care is also provided.The building has an entrance hall that leads into a large foyer/reception area which is furnished with comfortable armchairs and a hall table. The main administrative services are located here and include the office of the person in charge and the administrator. There is also a phone booth, recreational hall, visitors’ room and a chapel located off this area.There is a central kitchen where food is prepared, cooked and served to the adjoining dining room. There are three large sitting rooms and a conservatory area that overlooks Lough Swilly to the front of the building. A separate smoking room is also available. Other facilities include the chapel which adjoins the convent where the provider and religious community reside.Bedroom accommodation for residents consists of 18 single bedrooms and 15 double rooms some with shared and individual en suite shower and toilet facilities. In addition to the en suite facilities, there are three assisted bathrooms (with bath and toilet included) and six assisted toilets for residents’ use. A separate visitors’ toilet is also available.There is a driveway from the main road to the centre through a well maintained large garden and lawn. There is outdoor seating and tables available for residents’ use. The centre is wheelchair accessible and there is car parking for staff and visitors located at the front of the building.Nazareth House is situated in Fahan, Buncrana, Co Donegal on the 238 roadway. The centre adjoins the convent premises occupied by the Sisters of Nazareth Religious Congregation.*On day-two of the inspection there were 38 residents in the centre. One resident was in hospital.LocationDate centre was first established:1995DAY/MONTH/YEARNumber of residents on the date of*39inspection3Dependency level of Max High Medium Low current residents Number of residents 23 11 4 1Management structureThe nominated provider on behalf of the Sisters of Nazareth religious congregation is Sr. Alice Kirwan. She has overall responsibility for the management of the centre and reports to the order’s Regional Superior Sr. Cataldus Courtney and the Regional Director John O’ Mahoney, who both report to Sr. Mary Ann Monaghan, Superior General who is based in London.Wilma Hezil D’Souza is the Person in Charge and she reports to Sr. Alice Kirwan. The staff team report to the Person in Charge. This includes nurses, care assistants, housekeeping and laundry staff. There is also a catering manager, catering and dining room staff as well as maintenance and grounds staff. In addition, there are two administrative staff who provide clerical support for the centre.Staff Person Nurses Care Catering Cleaning Admin Otherdesignation in staff staff Charge laundrystaff Numberof 1* 2 8 2 3 1 3●staff on duty on day of inspection* During this inspection the person in charge was working off site following medical advice.● This number included the nominated provider on behalf of the Nazareth House community, the organisation’s chief executive and the maintenance man.and staff staff4BackgroundThe two inspections carried out by the Authority on 2, 3 and 4 April 2012 were triggered by a report of a significant number of resident deaths in the centre during March and April. At the time of the Authority’s inspections seven residents had died. In all nine residents died during the period 22 March to 8th April. Seven of these deaths are currently classified as possibly consequent to an influenza related illness. The remaining two residents died of unrelated causes. Five residents died in the centre and four died in Letterkenny General Hospital. No other residents were hospitalised. The average age of those who died was 89 years. Post mortems were not undertaken on any of those who died. The timeline of deaths is outlined below: 1st: 22 March 2nd 23 March 3rd: 29 March 4th :29 March 5th :31 March 6th :01 April 7th :02 April 8th :06 April 9th:08 AprilThe area public health team and infection control nurse were reviewing the situation on site. The inspections were undertaken to monitor the arrangements in place to ensure that the care and welfare of residents was appropriate during this outbreak.The first inspection was conducted on the night/morning of 2/3 April 2012. The interim guidelines for influenza management, the staff arrangements and infection control measures were discussed with the provider’s representative during this inspection. She assured the inspector that the availability of appropriate staff resources was a priority as well as controlling the outbreak. A copy of the interim guidelines compiled by the Health Service Executive (HSE) on the management of an influenza outbreak was left with the provider .The inspector identified the following actions to protect the health and welfare of residents to: ensure adequate staffing in centre ensure that a clear communication strategy was in place for relatives andresidents follow guidance provided by HSE public health officials ensure that cleaning practices and procedures were reviewed and in line withgood practice standards.The provider said she had discussed the deployment of staff with HSE and had been advised to consider employing agency staff, staff from other Nazareth Nursing homes or the HSE if needed.5Arrangements for the management of situation on site:The second inspection was conducted during the afternoon and evening of 3 April 2012 and during the day of 4 April 2012. The inspectors were updated by HSE Public Health on arrival. At that time the inspectors were told that the public health team were reviewing the circumstances of the seven residents who had recently died, ensuring preventative actions were in place for the remaining 38 residents in the centre and reviewing any changes to their health status. The residents who had influenza-like symptoms were being treated with antibiotics and with Tamiflu twice a day. Residents who did not have symptoms were treated with Tamiflu once a day. The inspectors were told that all residents were confined to their rooms and infection control measures were in place.There were 27 residents reported as symptomatic and swabs for analysis had been taken from 19 residents and one staff member. The results of the 20 swabs were received on the afternoon of 3 April 2012 and indicated that there were three confirmed cases of AH3 virus, five results were “weakly positive” and 12 were negative. The infection control nurse was repeating the “weakly” positive swabs and hoping to swab the remaining 18 residents. (There was a problem for the public health team as there was an insufficient supply of swabs to procure all samples on the first day.) There was one resident who was assessed as critically ill.Notices indicating that restricted visiting was in place were on display and all staff had been instructed by the infection control nurse to follow the standard infection control procedures.The public health personnel held regular national teleconference-calls with the Virus Reference Laboratory, the national health surveillance team and the media.The environmental health officers had been called in by public health staff and were on site. They had been asked to review the kitchen arrangements, the water supply and testing arrangements and the cleaning of equipment such as shower heads.The lead inspector outlined the role of the Authority and it was agreed that the inspectors would share their findings and conclusions with the HSE team. It was also agreed that the information being collated by the HSE such as the tracking of the infection would be provided to the inspectors when complete.StaffThe person in charge was on duty but away from the residential site in the convent area following medical advice. She was coordinating contacts with relatives and the supply of information to the public health team and to the Authority’s inspectors.The inspectors were told that there were 65 staff employed and at least three had been ill during the last few weeks. All staff had been requested to confirm if they had received the seasonal influenza vaccination. At lunchtime on Tuesday only one member of staff had confirmed this and arrangements were made to set up a clinic to administer the vaccination. This was very well attended and provided an opportunity for staff to have6their queries about the vaccination and the outbreak answered. The majority of staff received the vaccination.Previous regulatory activityThis centre has had two previous inspections. The registration inspection was conducted on 18 May 2010 and a follow-up inspection took place on 18 May and 15 June 2011.7Summary of findings from this inspectionNursing and care staff were very busy when the inspectors arrived at lunchtime on 3 April. The nurse in charge was responding to requests from relatives for information and coordinating the activities of the staff team. However, there were insufficient nurses on duty to address the increased workload particularly queries from families and the additional care required by residents who were ill. The person in charge could not carry out her role fully, as she could not be on duty in the residential area which increased the workload for the nursing staff. Furthermore, two nurses were unavailable to undertake additional work due to holiday and illness leave.The inspectors found that in general the health care arrangements for residents was satisfactory with significant interventions and specialist advice from local doctors and other professionals such as speech and language therapists recorded in the care records examined. Residents who exhibited symptoms of illness were seen expediently by their doctors or by the out-of-hours service and these contacts were recorded. There were also good contacts with hospital services and with the local palliative care team.Staff were familiar and knowledgeable about residents’ care needs. The inspectors noted that records and communication on the current health status were conveyed clearly at each handover, and the staff team were also noted to work well together to share the workload and monitoring arrangements.There were some deficits in the standard of cleanliness and hygiene and the maintenance arrangements for equipment. A number of shower chairs and commodes were not in a satisfactorily clean condition and were rusty.There appeared to be no established procedure to enable early detection of influenza in the nursing home. There was a lack of coordination of information available about residents with respiratory illness being cared for in the designated centre and residents who were admitted with respiratory problems to the general hospital. The inspectors concluded that a protocol to guide and inform professionals attending the centre, the person in charge and the acute hospital would be of benefit to ensure that outbreaks are appropriately identified, reported and contained. The inspectors are aware that the presentation of illness was not characteristic of influenza in all cases and that some residents presented with more acute symptoms than would be usual for influenza.There was a complete record outlining which residents had the flu vaccine. Only two residents did not have this and this was due to one resident being admitted to the centre after the vaccine had been administered and the other resident was ill on the day of administration. The resident group were noted to be highly dependant with 60% assessed as being of maximum dependency and 28% in the high dependency category.The majority of residents were in advanced old age with 35% of residents in the 70-80 age group and the remaining 65% of residents aged between 80 and 100.8Inspectors convened a meeting on Tuesday evening with HSE personnel, the Chief Executive for Nazareth House and others including one of the regular general practitioners. The inspectors outlined their findings in relation to staff workload particularly for the two staff nurses on duty during the day, the absence of cleaners after 15:00 hrs and the scheduling of only one nurse for night duty. The inspectors outlined their concerns regarding infection control and some of the inadequate practices that had been observed.The inspectors issued an immediate action letter to the provider requiring that: a nurse be nominated to take over the role of the person in charge for the period that she would be absent that infection control procedures and hygiene standards were implemented to a satisfactory standard in accordance with good practice guidanceappropriate facilities for communication were provided for residents confined to their rooms.At the conclusion of the inspection on 4 April 2012, the inspectors were informed that all matters were receiving attention and this has been confirmed in subsequent conversations with the provider. A nurse on the staff team had been appointed to take charge while the person in charge was off duty, a designated telephone was made available for residents to use in private when they received calls, and additional nursing staff had been employed during the day and night. The hours worked by cleaning staff had been extended. Weekly reports that outlined details of residents’ progress and how the outbreak was being contained were sent to the Authority. Throughout the inspection staff cooperated fully and provided information in a timely and organised manner.Infection Control ArrangementsCleaning and HygieneDuring the course of Tuesday afternoon the inspectors reviewed the premises, staff activity and care practice. The inspectors found staff had adequate supplies of person-protective equipment such as gloves, aprons and masks and were using these diligently. A carer told inspectors that precautions were dealt with in the following way: aprons and masks were in use at all times and masks were changed half hourly gloves were changed after each contact and all were disposed of in containers in each room staff were working in designated areas and not moving around the centre.The inspectors noted that hand gels were in use. However, these were not located in permanent positions, but were available on changing trolleys and tables.The inspectors found that some hand gels in critical areas such as sluices were not replenished in a timely way and one corridor, D, had no hand gel supply. Some yellow disposal bags were not securely fastened.Issues covered on inspection9Two household staff confirmed that they have a schedule for daily, weekly and monthly cleaning. They had safety information sheets that outlined the use of chemicals and what chemicals were to be used for specific situations. Carpets and floors were hoovered and cleaned daily. Bed tables and furniture were dusted and wiped clean. Curtains were laundered on a regular basis. The care staff have responsibility for cleaning equipment such as commodes and bathroom equipment.The inspectors found deficits in the overall standard of cleanliness that impacted on good infection control management. For example some commodes and bath chairs had not been cleaned effectively and were stained or damaged by rust. There was dust on the floor in some bedrooms. There was inappropriate storage of items such as, a hair brush and vases in the sluice. Shower tray outlets were also noted to be unclean and there was no system in place for the regular cleaning or limescale removal from shower heads.The laundry area was inspected. One of the regular laundry staff was on duty. The area was clean, tidy and well organised. She described the way laundry was managed. Soiled laundry is collected from the sluices in the residential areas by laundry staff. There is a designated entrance for soiled laundry and a designated exit for washed clean laundry. Laundry in red bags is secured when collected and this is placed directly in washing machines and washed at a temperature of 60 degrees Celsius. Clean laundry such as sheets are ironed with the rotary press, folded and returned to the linen storage cupboards.Sluice areasNew bed pan washers had been installed approximately two years ago. The bedpan washer was noted to have the facility to clean only one bedpan at a time. Inspectors noted a commode waiting to be washed in the sluice area on day 2 and staff informed the inspector that they were required to wait for the cycle to finish and in the circumstances there was a delay. No review of the situation had taken place during the outbreak. Records for the servicing of some equipment such as hoists and the bedpan washers were not available. The company CEO was advised of this by inspectors and made arrangements for the servicing of all three bedpan washers for 5 April 2012.Water managementThere were four drinking water dispensers units in situ. These were located in areas such as the activity/relaxation room and sitting rooms. The inspectors saw that there was a collection of stagnant water in one of the dispensing units.Inspectors met with the environmental health officer who inspected the kitchen area and the water storage and dispensing arrangements on 3 April 2012. She had reviewed the kitchen and she told inspectors she was satisfied that appropriate safe catering systems were in place. She informed inspectors that the temperature of cold water in the kitchenette in the areas known as B corridor was slightly elevated and a sample had been sent for analysis. The inspectors interviewed the maintenance person on day two. From the discussion, it was clear that there was no established process for legionella prevention. There was no regular routine for cleaning shower heads / shower outlets or10for flushing showers/ activating water taps in vacant rooms. Hot water temperatures were monitored monthly the inspectors were told.Waste managementThe waste management system in place was found to be satisfactory. The maintenance person was responsible for removing waste from the centre during the week and during evenings, nights and weekends a member of care staff is responsible for removing the waste when this staff member is off duty. The waste disposal area was noted to be clean and all bins were noted to be securely closed. Clinical waste is removed regularly by the Health Service Executive and there is a tracing system in place with a receipt issued at the time of collection.Staff arrangementsStaff were busily engaged with residents’ care. The staff allocation was operating the same as normal when the inspectors arrived. There were two nurses on duty with one taking charge during the period of the person in charge’s absence. The other nurse was from the HSE. The availability of nursing staff was depleted by the absence of the person in charge and the absence of two other nurses due to illness and holiday leave.There were eight carers on duty – all were regular staff. In addition there were three housekeeping staff on duty, two catering staff and one laundry staff member. The inspectors found that all housekeeping staff were scheduled to go off duty at 3 pm meaning that any cleaning that was required would revert to care and nursing staff. The centre also had a student undertaking a training course on placement at this time. The inspectors were told that there was appropriate insurance and Garda Síochána vetting in place. However, the system in place for the employment of staff was not in accordance with good practice guidance for the recruitment of staff to work with vulnerable people. There was no confirmation that indicated the student was medically and physically fit to undertake work with vulnerable people and the required three references were not available.The nurse in charge was engaged with telephone calls to concerned relatives, providing information to the teams on site and overseeing nursing care. There was a substantial number of telephone calls to attend to as visiting had ceased on Monday. From Friday to Monday visiting had been restricted to one visitor. There were also telephone calls from the media and media presence at the front door to contend with.The inspectors formed the view that there were insufficient nursing staff on duty to address the increased workload consequent to: the need to orientate new nurses due to the shortfall in the centre’s own staff the need to provide information to relatives and others on site the increased clinical vigilance required as a result of antibiotic treatmentand residents’ changing conditions added supervision requirements as residents were confined to their rooms11PremisesThe centre was generally comfortable and had many positive features such as spacious sitting areas, a good dining space with well spaced tables and an accessible garden area. The inspectors noted that the temperature in some rooms such as the smoking area and hairdressing room was cool, however these rooms were not in use during the isolation period. Records of temperatures recorded by the maintenance person also indicated that residents’ bedrooms were below the minimum recommended temperature of 21 degrees centigrade required where residents can sit out during the day.There was a designated smoking area and space to meet visitors in private. There was a range of assistive equipment such as specialist chairs and beds. However, the inspectors noted that some equipment such as hoists in bathrooms and specialist bath hoists did not appear to be serviced on a regular basis and the date on one bath hoist indicated it was last serviced in June 2009. An air bed pump in the nurses’ office had a notice indicating it was out of order since February 2012 and there did not appear to be a system in place for the timely repair of this equipment. The hand gel container in the hairdressing area was empty.CommunicationIt was unclear to the person in charge and provider where the report of the suspected flu virus had been generated. The inspectors were told that the visiting doctor had made contact with the public health office on the evening of Sunday 1 April 2012 as there were concerns expressed by staff about residents who were on antibiotic treatment and who were not responding as expected. The inspectors noted from the residents’ records examined, that changes in the health status of residents were reported in a timely manner to their doctors and that residents who were ill were seen expediently and reviewed on a number of occasions. The public health team advised the person in charge and provider about the suspected outbreak and the action that they would be taking to investigate the situation on Monday 2 April. There was no communication to the Chief Executive Officer of Nazareth House during the day and he only became aware of the situation at 18:15 hrs on Monday evening and was on site on Tuesday and met with the Health Service Executive staff and the Authority’s inspectors. The inspectors found that the governance arrangements between the person in charge/provider representative on site and the company head office were inadequate and did not facilitate the provision of adequate support to the person in charge and the staff team during the early stages of this critical event.The inspectors found that there was a need for better awareness among clinicians and staff in the centre to ensure that they were alert to the possibility of influenza as a cause of respiratory problems. As described earlier there was no established procedure to enable early detection of influenza in the nursing home. Communication between doctors attending the centre, the person in charge and the acute hospital required better coordination to ensure that the probability of an outbreak is considered, reported and contained to minimise risk. As a consequence of this outbreak the Authority, the Health Service Executive and the provider are completing an exercise to identify what12aspects of the management of the outbreak worked well and what areas need improvement.Staff were informed on Tuesday afternoon that the outbreak was confirmed as Influenza AH3 which is a recognised category of human influenza as defined by the World Health Organisation. Staff were also told that vaccinations would be available in the designated areas during the afternoon of 4 April. The need to ensure that staff allocated for duty had the flu vaccination, were dedicated to the centre and did not go to another centre for at least two days was highlighted by the public health team, as a precautionary measure.Residents were confined to their rooms as part of the required precautions for infection control. Inspectors found that many bedrooms did not have TVs, radios, or ready access to telephones, this left them very isolated. Communal areas did have televisions and radios. Arrangements to address this matter were put in place when this was identified. Residents were provided with a radio if they wished and the Chief Executive told inspectors that a telephone was provided for residents to enable them to speak with callers in private if they wished.The inspectors found that mobile telephone access and connection to the internet via Wi Fi was a constant challenge for anyone trying to access the internet in this manner during the outbreak. Residents’ care records and other documentation that were maintained on the computer system were accessible as hard wire internet connection was available. The poor arrangements for internet access compromised the ability of outside professionals to obtain and relay information in a timely manner.The inspectors found that there was good communication between the staff team and between staff, residents and families. Staff knew residents very well, were very engaged with them when undertaking personal care and were familiar with their personal preferences and choices. They were noted to spend time talking with residents and family members when they telephoned and reassuring them about the need for isolation and the actions that were being taken to ensure the outbreak was under control. Nurses provided comprehensive information to their colleagues during handovers. The inspectors were present for the handover to night staff on 3 April and for the morning handover the next day. Information was relayed about residents who were ill and who needed additional care and developments during the day/night. There were records maintained of the regular observations and changes and an overview of the situation was provided.There was visual signage on the front door in relation to visiting restrictions, however, there was no signage that described the specific measures that help reduce further contamination such as respiratory /cough etiquette. Once brought to the attention of staff, this was addressed.There were no complaints of and no incidents of elder abuse recorded for 2012. A relative told inspectors that she was very satisfied with care and support from nursing staff and said that the care provided to her relative was satisfactory in all aspects.13HealthcareThe inspectors found that in general the healthcare arrangements for residents was satisfactory with a significant number of contacts from local doctors and other professionals such as speech and language therapists available in the care records examined. Residents who exhibited symptoms of illness were seen expediently by their doctors or by the out-of-hours service and these contacts were recorded. There was also good contacts with hospital services and with the local palliative care team.The information on residents’ healthcare needs was easy to access. There was for example a complete record outlining which residents had the flu vaccine. Only two residents did not have this and this was due to one resident being admitted to the centre after the vaccine had been administered and the other resident was ill on the day of administration. The resident group were noted to be highly dependant with 60% assessed as being of maximum dependency and 28% high dependency. Inspectors found that 35% of residents were in the 70-80 age group and the remaining 65% of residents were aged between 80 and 100.The inspectors examined the medical care records of nine residents including the records of the seven residents who had died during the past month. The centre had good access and support from local primary care services. There were details of all medical contacts, changes in healthcare status and treatments ordered in the residents’ files. During March there were four residents admitted to the centre and three of these admissions were short-term respite care admissions. One person was admitted twice in March. Each admission lasted one week after which she returned home. One respite resident who was discharged home in the first week of March was re-admitted to the centre from the general hospital having been admitted from home. There were four residents admitted to hospital. Two were admitted for treatment for pneumonia and pulmonary oedema respectively. The other two residents were admitted for investigations relating to falls and one was receiving care from the palliative care team at the time of admission. The cause of death in this case was recorded as myocardial infarct/sudden death. The deaths of the three residents who died in the centre were attributed to pneumonia in two cases and to a cardiovascular accident and possible chest infection in the third instance. The inspectors noted that all residents had been medically reviewed on a number of occasions during February and March.The inspectors did not examine medication management arrangements during this inspection as the findings of inspectors during the follow up inspection conducted on 18 May and 15 June 2011 indicated that deficits in medication management identified during the registration inspection had been appropriately addressed. The inspectors did note that nursing staff organised well for medication rounds and ensured that trolleys were locked when they were in rooms administering medication. Vaccines were stored appropriately in the fridge and there was an alarm to alert staff if the temperature was not adequate.14TrainingThe training record maintained by the person in charge outlined the qualifications and training attained by staff. The record conveyed that the staff team had received training on the statutory topics of moving and handling, elder abuse prevention and fire safety during 2011. Training on other topics such as infection control and health and safety had also been provided for staff in July 2011 however it was noted that only 22 out of 65 staff had attended infection control training.Risk managementThe inspectors found that there were deficits in assessing risk and potential hazards.The centre did not have adequate contingency arrangements in place for staff shortfalls. Although there were a number of staff who worked part-time hours there was a deficit in the nursing time available to cover illness and holiday absence. There was insufficient cover for the absence of the person in charge. The nurse nominated to take charge only worked two days each week. The inspectors were told that a recruitment drive for nurses was underway and that interviews had taken place and posts were due to be offered to the successful applicants.There were no systems in place for the monitoring and prevention of hazards such as legionella or for the timely repair of essential equipment such as air beds.The kitchenettes in the residential area did not have dishwashers. These had been removed and it was not clear if this change had been appropriately risk assessed. Staff now take crockery and cutlery to the main kitchen to be washed which could present an infection control hazard during an outbreak.There was no information available during the inspection that indicated that all deaths had been notified to the coroner. The inspectors have been informed that the deaths that occurred on 1 and 2 April were notified on 3 April. The notification that an infectious illness was present in the centre had not been made to the Health Information and Quality Authority without delay as required by Regulation 36; Notification of Incidents. The notification was made on 4 April following confirmation of the diagnosis of influenza on the afternoon of 3 April.There were records maintained of accidents and incidents. However, the information recorded when residents’ sustained falls did not indicate if the fall was witnessed or if the resident was alone. There was no information that indicated if neurological observations were recorded if a fall was unwitnessed or if a resident sustained a head injury.Policies and procedures that guide practice in infection control and risk management needed revision. The emergency plan also needed revision to include the arrangements in place to address an outbreak of infectious illness, the contingency measures to address staff shortfalls and the management of communication during a critical event.15In this situation the tracing of residents and staff movements in and out of the centre and the tracking of staff who worked in this centre and other areas was identified as a possible hazard to other vulnerable persons. The public health team were reviewing this as part of their enquiries. The inspectors requested that the provider compile a list of staff who worked part-time in the centre and who were known to work in other clinical areas and this was forwarded to the team.Report compiled by:Brid McGoldrick and Geraldine Jolley Inspector of Social Services Social Services Inspectorate Health Information and Quality AuthorityDate: 10 April 2012Chronology of previous HIQA inspectionsDate of previous inspection:Type of inspection:18 and 19 May 2010RegistrationScheduled Follow-up inspectionAnnouncedUnannounced18 May 2011 and 15 June 2011Registration Scheduled Follow-up inspectionAnnouncedUnannounced16Health Information and Quality AuthoritySocial Services InspectorateAction PlanProvider’s response to inspection reportCentre:Nazareth HouseCentre ID as provided by0368the Authority:Date of inspection:2,3 and 4 April 2012DAY/MONTH/YEARDate of response:08/05/2012DAY/MONTH/YEARRequirementsThese requirements set out what the registered provider must do to meet the Health Act2007, the Health Act 2007 (Care and Welfare of Residents in Designated Centres forOlder People) Regulations 2009 and the National Quality Standards for Residential Caresettings for Older People in Ireland.1. The provider is failing to comply with a regulatory requirement in the following respect:While the Person in Charge was off duty due to medical advice from the public health team there was no designated person in charge. The arrangements to cover the absence of the person in charge were not adequate as the nurse nominated for this role only worked two days each week.Action required:Put in place an appropriately qualified and experienced person in charge.Reference:Health Act 2007 Regulation 15: Person in Charge Standard 27: Operational Management.Please state the actions you have taken or are planning toTimescale:take with timescales:17Provider’s response:A senior nurse was appointed acting nurse manager during the short term absence of the person in charge until the outbreak was decalred over.04/04/20122. The provider is failing to comply with a regulatory requirement in the following respect:Aspects of infection prevention and control required improvement as a result of the confirmed outbreak of influenza A (H3N2). There were deficits in aspects of infection prevention and practice and areas where supervision was required. Some areas did not have appropriate accessible supplies of products such as hand gels to assist in good infection control management and some equipment and areas of the premises were not in a satisfactorily clean condition. Staff training records indicated that not all staff had attended training on infection prevention and control.Action required:Implement in full the guidelines and practices as outlined in relation to influenza and infection control in: 6: H Interim Guidelines on the Prevention and Management of Influenza Outbreaks in Residential Care Facilities in Ireland 2011/2012 Heath Information and Quality Authority’s National Standards for the Prevention and Control of Healthcare Associated Infections (2009)Action required:Ensure that responsibility for infection prevention and control is clearly defined and that there are clear lines of accountability for infection prevention and control throughout the designated centre.Action required:Ensure equipment is clean and maintained in a hygienic condition to minimise the spread of infection and that supplies of equipment and products for good infection control management are readily available.Reference:Health Act 2007 Regulation 31: Risk Management Procedures Standard 26: Health and SafetyPlease state the actions you have taken or are planning toTimescale:take with timescales:Provider’s response:18The Health Information and Quality Control National Standards for the Prevention and Control of Healthcare Associated Infections and the HSE – Interim Guidelines on the Prevention and Management of Influenza Outbreaks in Residential Care Facilities in Ireland 2011-2012 were implementedA named person responsible for Infection Prevention and Control is in place with clear lines of accountability throughout the centre.As part of the monthly Infection Control Audit for all departments, the person in charge will ensure that equipment is clean and maintained in a hygenic condition and products for good infection control are readily availble.Immediately ImmediatelyImmediately3. The provider has failed to comply with a regulatory requirement in the following respect:There was insufficient staff or skill mix to meet the assessed needs of residents taking into account the declared dependency levels, clinical monitoring requirements, changing needs, the number of residents accommodated and the size and layout of the centre. There was no household staff available after 3pm daily and there was inadequate nursing staff available to cover absences due to illness and holidays.Action required:Ensure that the numbers and skill mix of staff are appropriate to the assessed needs of residents and the size and layout of the designated centre.Action required:Have cleaning and ancillary staff available throughout the day in accordance with the assessed needs of residents.Reference:Health Act 2007 Regulation 16:Staffing Standard 23: Staffing Levels and QualificationsPlease state the actions you have taken or are planning toTimescale:take with timescales:Provider’s response:The staff numbers and skill mix to meet the assessed needs of residents and the size and layout of the centre during the outbreak were reviewed and addressed by the providerImmediately19Additonal nurses were engaged from the HSE and from recruitment agencies during the outbreak period to meet the changing needs of the residents and to cover absences due to illness and holidaysHousehold staff were made available for two additional hours each day in accordance with the assessed needs of residents.Immediately Immediately4. The provider has failed to comply with a regulatory requirement in the following respect:Robust communication procedures were not in place. Senior management was not communicated with in a timely manner and there was a lack of clarity and accountability about how information on the outbreak had been reported. There was a lack of coordination of the information available where residents were diagnosed with a respiratory illness and were being cared for in the designated centre or in hospital. There was no system to alert professionals to the possibility of an influenza outbreak which created additional risk.Action required:Have in place a risk management policy that covers, but is not limited to, the identification and assessment of risks throughout the designated centre and the precautions in place to control the risks identified.Action required:Have in place a protocol for communicating with general practitioners (GPs), community provider services and other designated centres to ensure locally appropriate arrangements are in place for reporting suspected outbreaks of infectious illness.Action required:Revise the policies and procedures on communication to reflect learning consequent to this outbreak and ensure that there are clear communication pathways outlined in the emergency plan and in the communication procedure.Action required:Have in place appropriate systems for communication to ensure that risks, such as infection20control problems can be adequately managed.Reference:Health Act 2007 Regulation 11: Communication Standard 20: Social Contacts Standard 29: Management SystemsPlease state the actions you have taken or are planning toTimescale:take with timescales:Provider’s response:The risk management policy covering the identification and assessment of risks throughout the centre and the precautions in place to control identified risks are under review and a revised policy will be put in place.A protocol for communicating with GPs, community provider services and other designated centres will be developed to ensure locally apporpriate arrangements are in place for reporting suspected outbreaks of infectious diseases. Continuing discussions/debriefings with the local public health body should help provide the centre develop a robust communication procedure document.Revised policies and procedures to reflect the learning consequent to the outbreak will be completed with clear communication pathways outlined in the emergency plan and in the communications procedureAppropriate systems for communication to adequately manage risks such as infection control are in placeWhile the designated centre fully upgraded its IT systems and internal cabling (CAT 5) eighteen months ago, the internet providers have an under-developed residential and business broadband service in the Fahan area with poor levels of DSL and cable modem adoption compared with major cities in Ireland. The centre was informed that limited coverage, for both mobile phone services and for the internet in the Fahan area, like in many non-urban areas in other parts of the country, will remain15/06/201230/06/201230/06/2012 ImmediatelyOngoing215. The person in charge has failed to comply with a regulatory requirement in the following respect:A number of residents had respiratory-type illness and there were clear indicators that there was an outbreak of an infectious illness. Notification was not submitted to the Chief Inspector in a timely manner as required by the regulations.Action required:The person in charge shall ensure that notice is given to the Chief Inspector without delay of the occurrence in the designated centre of outbreaks of any infectious disease.Action required:Have in place procedures to guide and inform staff on the records to be maintained and the notifications to be made to the Authority.Reference:Health Act 2007 Regulation 36: Notification of Incidents. Standard 26: Health and SafetyPlease state the actions you have taken or are planning toTimescale:take with timescales:Provider’s response:Residents with respiratory illness were reviewed regularly and were treated for bacterial infection. An oubreak was not suspected until late 01.04.2012.The person in charge was informed regarding a suspected outbreak on the afternoon of 02.04.2012 by the public health and who also informed the centre that the Health Information Quality Authority had been notified.The person in charge will ensure that notice is given to the Chief Inspector without delay of the occurrence of outbreaks of any infectious disease in the centreProcedures are in place to guide and inform staff on the records to be maintained in the centre and the notifications to be made to the Authority.ImmediatelyImmediately226. The provider has failed to comply with a regulatory requirement in the following respect:There were aspects of the premises that required remedial action.While new boilers had been installed, the temperatures recorded were below the recommended minimum temperatures in some bedrooms and the smoking and hairdressing areas were noted to be cool.Not all equipment had up-to-date service records. There was no clear process for managing equipment that required repair.Dish washers in the small kitchen areas had been removed and crockery and cutlery had to be conveyed to the main kitchen to be washed which created an infection control hazard .Action required:Ensure that ventilation, heating and lighting suitable for residents, is provided in all parts of the designated centre which are used by residents.Action required:Ensure that equipment provided at the designated centre or used by residents or persons who work at the designated centre is maintained in good working order.Action required:Ensure that appropriate equipment is provided to enable staff to operate appropriate infection control measures.Reference:Health Act, 2007 Regulation 19: Premises Regulation 31: Risk Management Procedures Standard 25: Physical EnvironmentPlease state the actions you have taken or are planning toTimescale:take following the inspection with timescales:Provider’s response:Ventialtion, heating and lighting suitable for residents is provided in all parts of the centre .The hairdressing and smoking rooms are used infrequently and are heated when in use. Room temperatures are monitored in all areas of the building on a regular basis.A clear process is in place to ensure the timely repair andImmediately23maintenance of the equipment. Maintenance contracts for equipment where one did not exist have been sourcedChecklists/audits are carried out to ensure approporiate equiment is in place to enable appropriate infection controlThe provider had removed a domestic diswasher from the kitchenette located in the bedroom area of the centre so that all dishes/cutlery are washed in the main kitchen washup area which has an industrial dishwasher. This was undertaken so that clean dishes left the kitchenette and only clean ones were returned.Immediately 30/05/2012Ongoing7. The provider has failed to comply with a regulatory requirement in the following respect:There was a deficit in the management of potential risks and hazards. Shower tray outlets were noted to be unclean and there was no system in place for regular cleaning or limescale removal from shower heads.Action required:Have in place a comprehensive risk management policy that is implemented throughout the designated centre.Action required:Ensure that the risk management policy includes arrangements for the cleaning of parts of the premises and equipment that may present hazards in accordance with good practice guidance.Reference:Health Act 2007 Regulation 31: Risk Management Procedures Standard 26: Health and SafetyPlease state the actions you have taken or are planning toTimescale:take with timescales:Provider’s response:A comprehensive revised risk management policy is implemented throughout the centre which includes a schedule for monthly shower head and shower tray outlet cleaning to be carried out by the maintenance personAudits/checklists are carried out to ensure that arrangements are in place for the cleaning of parts of the premises and equipment that may present hazards in accordance with good practice guidanceImmediatelyImmediately248. The provider has failed to comply with a regulatory requirement in the following respect:Residents’ care records were maintained on a computer system and other information needed to be conveyed in a timely manner. However, the poor arrangements for internet access and poor telephone coverage compromised the ability of staff to communicate or access information or provide information in a timely manner when required.Action required:Ensure that the arrangements in place for maintaining residents’ records and for relaying information can be supported by the structures in place and that precautions are in place to control the risks identified such as poor internet access.Reference:Health Act 2007 Regulation 31: Risk Management Procedures Standard 26: Health and SafetyPlease state the actions you have taken or are planning toTimescale:take with timescales:Provider’s response:While the designated centre has a modern fully upgraded IT system, including a computerised care records sytem, and internal cabling (CAT 5), the internet providers have an under-developed residential and business broadband service in the Fahan area with poor levels of DSL and cable modem adoption compared with major cities in Ireland. The centre was informed that limited coverage, for both mobile phone services and for the internet in the Fahan area, like in many non-urban areas in other parts of the country, will remain.The computerised resident’s care records were fully accessible during the inspection.Contingency plans are in place in the event of internet failure. The daily nurse’s handover report is now revised to include specific information regarding resident’s condition and treatment .Written documentation of a daily record is already available in the event of poor internet access.OngoingImmediately9. The person in charge has failed to comply with a regulatory requirement in the following respect:25There were records maintained of accidents and incidents. However, the information recorded when residents sustained falls did not indicate if the fall was witnessed or if the resident was alone. There was no information that indicated if neurological observations were recorded if a fall was unwitnessed or if a resident sustained a head injury.Action required:Have in place a record of accidents and incidents that describes the event fully and that indicates the actions taken following the event to protect residents.Reference:Health Act 2007 Regulation 36: Notification of Incidents Standard 26: Health and SafetyPlease state the actions you have taken or are planning toTimescale:take with timescales:Provider’s response:An amended Accident and Incident form is now in place to include recorded neurological assessments, witnessed or unwitnessed events and actions taken following the eventImmediately10. The provider has failed to comply with a regulatory requirement in the following respect:A number of polices were not comprehensive and did not provide sufficient guidance for staff. This included the infection control procedure and the emergency plan which required revision to include the arrangements in place to address an outbreak of infectious illness, the contingency measures to address staff shortfalls and the management of communication during a critical event.Action required:Have in place the records, policies and procedures to be maintained in designated centres as outlined in schedules 4 and 5.Reference:Health Act 2007 Regulation 31: Risk Management Procedures Standard 26: Health and SafetyPlease state the actions you have taken or are planning toTimescale:take with timescales:26Provider’s response:The Infection control policy and emergency policy are now revised to include the arrangements to address an outbreak of infectious illness, the contingecy measures to address staff shortfalls and the management of communication during a critical event.The records , policies and procedures as outlined in schedule 4 S. I . No 36 of 2010 and schedule 5 S.I. No 36 of 2009 are maintained in the centreImmediately11. The provider has failed to comply with a regulatory requirement in the following respect:The procedures in place for vetting staff who work with vulnerable people were not in accordance with legislation and good practice guidance. There were no references and no evidence of medical and physical fitness for a member of staff employed.Action required:Ensure that the designated centre has written policies and procedures relating to the recruitment, selection and vetting of staff.Action required:Persons shall not be employed at the designated centre unless the provider has obtained in respect of that person the information and documents specified in Schedule 2 which includes references from three sources and evidence of medical and physical fitness.Reference:Health Act 2007 Regulation 18: Recruitment Standard 22: RecruitmentPlease state the actions you have taken or are planning toTimescale:take with timescales:Provider’s response:Written Policies and procedures relating to the recruitment ,selection and vetting of staff are updated to include procedures and policies on the engagement of students on work placement and that the information and documents in relation to these persons is in place prior to commencing work in the centreImmediately27Any comments the provider may wish to make:Provider’s response:The provider, person in charge and staff, as well as the Public Health team on site during the outbreak,found the inspection to be constructive and helpful.The inspection team were professional and courteous to residents, visitors and staff.The debriefing sessions since the inspections with the inspectors, the Public Health team and the centre and the inspector’s recommendations inform learning for future management of outbreak situations in nursing homes.The management and staff of Nazareth House Fahan wish to thank the inspection team for their support and are committed to addressing the recomendations in the report.Provider’s name: Sr Alice Kirwan on behalf of the Sisters of Nazareth Date: 09/05/201228HEALTH AUTHORITY CRITICISES HYGIENE AT FLU DEATH NURSING HOME was last modified: May 11th, 2012 by BrendaShare this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to share on Pocket (Opens in new window)Click to share on Telegram (Opens in new window)Click to share on WhatsApp (Opens in new window)Click to share on Skype (Opens in new window)Click to print (Opens in new window)
Creighton Edges Drake, 108-100, In Epic Four-Overtime Contest
DES MOINES, Iowa – The Drake University women’s basketball team matched program history by going into quadruple overtime in a 108-100 loss against Creighton on Sunday, Dec. 3 afternoon at the Knapp Center. It was just the second four-overtime contest in program history with the first taking place against UNI on Jan. 23, 1993 at home in a game won by Drake, 112-106. Down by six points with 4:22 to play in the fourth quarter, Drake had a much-needed defensive spark to close the quarter and paired it with a 6-0 run to force overtime at 71-71. Preview Buy Tickets Live Stats 1350 ESPN Des Moines The Valley on ESPN3 Listen Live Watch Live Creighton fired off with the first two points in the third overtime, but Bachrodt answered with a layup to tie the game at 86-86. A layup from Rhine and two points from Hittner sent the Bulldogs to the lead at 90-86. Later a jumper from Bachrodt with two seconds left and the shot clock expiring put the Bulldogs up 92-90. However, Creighton made two free throws after a foul call with 0.9 seconds left. Bachrodt had another desperation heave that rolled out as the game was sent to the fourth overtime. Next Game: Iowa Wesleyan 12/5/2017 – 11 AM In the fourth overtime, Creighton scored the first points with a three-pointer to take the lead 95-92. Hittner made one of two free throws to pull within two points, but the Bluejays ripped off six straight points to build a cushion they would never relinquish as the Bulldogs’ impressive 21 -game home court winning streak that started on Feb. 5, 2016 came to an end. Full Schedule Roster On Sunday, Drake (4-4) was led in scoring for the third consecutive game by redshirt sophomore Sara Rhine (Eldon, Mo) with 25 points. This is Rhine’s third game in a row scoring more than 20 points. Four other Bulldogs scored double-figure points as sophomore Becca Hittner (Urbandale, Iowa) had 18 points and two steals followed by 17 points from sophomore Brenni Rose (Shawnee, Kan.) and 16 from junior Sammie Bachrodt (Wichita, Kan.). Redshirt junior Becca Jonas (Independence, Mo.) added a season-high 10 points and recorded her first double-double of the season with 10 rebounds. HTML Box Score In the first overtime, Creighton and Drake wrestled to take the lead. Rose and Rhine contributed with six free throws, collectively. With a layup from Rose in the final minute, the Bulldogs tied the Bluejays at 79-79 to force a second period of overtime, Jonas nearly won the game with a last second shot attempt that missed. In the second overtime, Rose contributed two free throws to take back the lead, 81-79. After a three-pointer from Creighton, the Bulldogs fired back with a layup from Bachrodt to tie once again, 84-84, with 49 seconds left. Later each team had chances to win it but each fell short as it went to a third extra period. With a three-pointer from Jonas to start the game, Creighton (4-3) fell behind in the first quarter after Drake scored the first 11 points. With 2:24 minutes left in the second quarter, Creighton briefly took the lead, 29-27. With two points from Jonas and five from Hittner, Drake fired back to lead 34-29 at halftime. In the third quarter, the Bluejays stormed back to lead by as many as nine points, helped by a 72.2 shooting clip, including knocking down six three-pointers. Story Links Following Sunday’s game, Drake welcomes Iowa Wesleyan Tuesday morning for the program’s annual Pack the Knapp for Character presented by the YMCA of Greater Des Moines game. Tipoff is scheduled for 11 a.m. with thousands of Des Moines and local area elementary and middle school students scheduled to attend for a fun morning of Bulldog basketball and educational activities. Print Friendly Version
PHOTOGRAPHER DIES AFTER FALLING FROM ROCKS INTO SEA AT FANAD LIGHTHOUSE
The scene at Fanad Lighthouse in north Donegal this afternoon as the Irish Coast Guard Rescue helicopter taking the victim ashore following a search and rescue operation. Photo by John McAteer.FANAD TRAGEDY UPDATED: A man has died after falling off rocks and into the sea at Fanad Lighthouse.The man, understood to be from Co Antrim, was taking photographs at the time.It is believed the man lost his footing and fell into the sea and became trapped in a gulley on the cliffs. Another person on the scene contact Malin Head Coast Radio station at 2.42pm.A full rescue mission was launched with two lifeboats from the Lough Swilly RNLI at Buncrana as well as the Mulroy Coastguard and the Rescue 118 helicopter from Sligo were launched.Two other local fishing boats, the Mary Ellen and the Annie, who were also in the area, also rushed to the scene.The rescue boats cold not get to the casualty because of a Force 7-8 gale blowing north-westerly towards the shore. The Mulroy Coastguard boat eventually managed to extract the casualty and took him to shore where the Rescue 118 chopper took him to Letterkenny General Hospital.CPR was performed at the scene.However the man, who is in his 60s, was pronounced dead a short time later at the hospital.A spokesman for Malin Head Radio coastguard said conditions were very bad at the time of the incident which heavy seas and gale force winds.A spokesman appealed to people to take extra care when walking or exploring the coastline. Fanad Lighthouse is one of a number of lighthouses around the country which has received a renovation and development grant and is due to open to the public next year.PHOTOGRAPHER DIES AFTER FALLING FROM ROCKS INTO SEA AT FANAD LIGHTHOUSE was last modified: August 17th, 2014 by StephenShare this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to share on Pocket (Opens in new window)Click to share on Telegram (Opens in new window)Click to share on WhatsApp (Opens in new window)Click to share on Skype (Opens in new window)Click to print (Opens in new window)Tags:cliffsdeathfallfanad lighthouseRESCUE 118RNLI
Man’s car became airborne during high-speed Garda pursuit
A Letterkenny man has been ordered to do 120 hours community service after what was described as an “appalling case” involving a high-speed chase through areas of the town.Gardai had detected John McKelvey of Correnagh driving at a speed of 147 kms in a 100km zone when they were operating a speed check-point at Dromore on January 25th last. A previous sitting of the court had heard that the 21-year-old defendant, who faced five charges of dangerous driving, had failed to slow down and had continued on in the direction of Lurgybrack.Gardai reported that he had been travelling at 115 km as they approached a humpback bridge and the car had become airborne.The defendant had continued on driving at between 110 and 120 kms per hour before Gardai decided to stop pursuing it as it was deemed unsafe.Shortly afterwards, Garda Kilcoyne spotted the defendant’s vehicle, a black Corsa, having crashed into a ditch. McKelvey had subsequently been arrested at just after 3.a.m. following the 18 km pursuit.Defendant’s solicitor, Patsy Gallagher said his client understood that his behaviour could have resulted in a fatality.He had observed the blue lights of the Garda patrol car and had subsequently panicked.Addressing Letterkenny District Court, Judge Paul Kelly said it was an “appalling case” involved a pursuit that had lasted up to thirteen minutes at high speed.Mr Gallagher told the court that his client had undertaken the Pro-Social Drivers course which had been “extremely beneficial” to him. “He has learned his lesson and the Probation Report on him is good.”McKelvey is now residing and working in Waterford.Judge Kelly agreed that the Probation Report had been “very positive” and noted that the defendant had completed the Pro-Social Drivers course.He ordered him to undertake 80 hours of community service in relation to one of the charges while disqualifying him from driving for two years.He further imposed 40 hours of community service on a second charge with a disqualification period of two years.The charges are to run consecutively.Man’s car became airborne during high-speed Garda pursuit was last modified: December 14th, 2017 by StephenShare this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to share on Pocket (Opens in new window)Click to share on Telegram (Opens in new window)Click to share on WhatsApp (Opens in new window)Click to share on Skype (Opens in new window)Click to print (Opens in new window) Tags:courtdangerous drivingdonegalGardaiJOhn McKelbeyletterkenny
SA launches tech dictionaries
27 September 2005Although South Africa has 11 official languages, only two of these, English and Afrikaans, are used in many technical fields.Now, three new multilingual dictionaries will bring these fields within the reach of all South Africans, no matter which language they speak.Speaking at the launch of the publications in Boksburg on Monday, Arts and Culture Minister Pallo Jordan said the dictionaries would establish wider use of South Africa’s indigenous languages in technical fields.The dictionaries – covering natural science and technology glossary for schools, information and communications technology, and parliamentary/political terms – are translated into IsiZulu, IsiXhosa, IsiNdebele, TshiVhenda, SiSwati, Sesotho, Sepedi, XiTsonga and SeTswana.Jordan said he was “convinced that multilingualism is a possibility in this country if we continue to work together.”The natural science and technology dictionary will be distributed to various primary schools for use by teachers and learners while the parliamentary/political glossary will be distributed to translators throughout the country as well as language practitioners in various provincial legislatures.Source: BuaNews