Observations
Based on client record review, the facility failed to assist the client in obtaining medical supportive services when necessary in one of one client records.The findings include:An onsite complaint investigation was conducted on February 1, 2012. Four client records were reviewed. One client required medical follow up. Client record #1 included documentation of treatment at a hospital due to a diagnosis of salmonella food poisoning. The discharge paperwork completed by hospital staff instructed the client to follow up with a doctor in 2-4 days for re-evaluation and further treatment. Client #1 did not receive medical follow up within 2-4 days and there was no documentation of the facility's attempt to assist the client in arranging a follow up appointment within 2-4 days as instructed by hospital staff.Interviews took place with the project director and clinical supervisor throughout the investigation. It was confirmed that there was no documentation to illustrate efforts to assist the client in obtaining medical support service follow up.
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Plan of Correction
The Facility Director and Clinical Supervisor will ensure the facility will direct our clients to follow through with all medical appointments. This will be accomplished by setting up appointment date and times,providing transportation to clients, or any other methods to ensure follow up. Regardless of whether they choose to follow through or not, the client response shall be noted in the client record under a progress note or the incident report form. The Clinical Supervisor will review the records to monitor ongoing compliance.
The Facility Director will review our policies and procedures with the support staff and the cook at our monthly staff meeting to be held no later than February 29, 2012. The topics for training shall cover proper food handling, food temperature logs and proper storage and refrigeration of all foods. As follow up, the Facility Director will periodically inspect the kitchen area and the food temp logs to ensure compliance with facility policies. The Facility cook will monitor support staff and residents for compliance on a continual basis. Clients will not be permitted to remove perishable food items from the dining room to their dormitory rooms.
After an exhaustive internal investigation conducted by the Facility Director, it is still a mystery to facility staff as to how only one client could have contracted salmonella on site. No one else at our facility (including staff who eat lunch/dinner on site) contracted the bacteria on that day or any other day. Due to this, we believe it is highly likely the client contracted the bacteria outside of this facility. In any event, we will diligently enforce our policy of no outside food items being brought into the facility. We will continue to maintain a log of all client activities outside of the facility and will include documentation in the client record listing the client's outside activities should any client fall ill or be injured.
At Davis Archway we believe we've diligently applied safe and sanitary practices at our facility kitchen and serving area. Since this incident has come to our attention, we have been extra observant and considerate of our food handling practices.
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