Food safety concerns at old people's home

An audit of St Vincent de Paul Residence found medical and nursing services to be of a satisfactory level but there was "a high risk of an outbreak of food-borne diseases" in the kitchen.

The audit was conducted by the Auditor General, Joe G. Galea and presented to Parliament yesterday.

He said the main findings of an audit carried out between November 2003 and November 2004 were that:

¤ Generally, residents were satisfied with the level of medical and nursing/caring services provided;

¤ An audit trail in the admission process was lacking;

¤ Residents gave a poor rating to catering services;

¤ The provision and management of leisure activities was inadequate.

The survey revealed that the vast majority of residents and their visitors were generally satisfied with the medical and caring services given.

Such services were provided courteously and respected the residents' dignity.

A minority of residents and visitors raised concerns, mainly related to the delivery of these services.

Some 12 per cent of residents and visitors said they tipped nurses/care workers, raising questions on the ethical behaviour of recipients and the equitability in the delivery of services to residents.

As for catering services, the audit found that the home did not employ a dietician who could plan for individuals suffering from medical conditions such as diabetes.

Moreover, inspection of the kitchen raised concern.

"Food safety is another aspect of concern at St Vincent de Paul. The Institutional Health Inspectorate Unit of the Health Division had conducted various inspections at SVDP kitchen. Most of the deficiencies reported were not rectified and kept reappearing in subsequent inspection reports. The last inspection, which was carried out in August 2004, rated the kitchen at grade D - the unit grades kitchens on a scale of A to F with A being the top grade. Furthermore, two inspections that were conducted in April 2004 and August 2004 reported a high risk of the kitchen having an outbreak of food-borne diseases".

The majority of residents participating in the survey gave a poor rating to the food provided at the home.

On the admissions process, the Auditor General said that although the Admissions Board had been functioning since 1999, its terms of reference were only issued in April last year and the board had no regulating statute.

Since January last year, only applications endorsed as urgent by a medical doctor or a social worker were referred to the board. Other applications were not considered for admission.

"Changes to the admissions priority list, on account of deterioration in the applicant's medical or social condition, were not adequately documented by the board, undermining the audit trail for fairness and equity".

The audit also found that residents of St Vincent de Paul had a minimum of 6.5 hours of free time every day and most of it was not utilised, rendering the residents passive. The entertainment section of the home lacked the organisational capabilities and skills to optimise the residents' free time. The home also lacked the culture of involving the residents or their representatives in the decision-making process and residents were rarely consulted about leisure activities.

In his recommendations the Auditor General suggested that:

¤ The admissions process be made more transparent. He suggested that weightings should be given to the various criteria considered for admissions and these should be published. Moreover, the admissions process should b documented to ensure transparency and accountability;

¤ The quality of catering services needed to improve. Management initiatives to seek other methods of providing catering services, such as contracting out, should be actively followed up and the options should be evaluated as a matter of priority. In the meantime, deficiencies identified by health inspectors regarding food preparation and storage should be rectified immediately;

¤ A dietician should be engaged to ensure that the residents' individual dietary requirements are addressed;

¤ Leisure and entertainment activities at the home should be improved in quality, frequency and variety. There should be closer coordination between the Entertainment Section and the Occupational Therapy Department;

¤ The management should remind staff of government policies on the acceptance of gratuities and gifts.