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SINCE THE BEGINNING of the Covid-19 crisis in Ireland, multiple allegations have been made regarding a lack of social distancing, visitation issues and staff not adhering to guidelines in nursing homes across Ireland.
Further complaints were also raised about the quality of care given in some nursing homes during the crisis.
That’s according to documents released to TheJournal.ie under the Freedom of Information Act.
Between 1 March and 1 October 2020, the Health Information and Quality Authority (Hiqa) received more than 800 pieces of information raising issues of concern in relation to older persons’ services in Ireland.
Hiqa is responsible for the monitoring, inspection and registration of designated centres for older people, such as nursing homes, in Ireland.
The concerns are heavily redacted in places. All identifying material relating to the centres and people involved is removed, in order to respect their privacy.
Despite this, the concerns give a real glimpse into the issues in residential care centres and nursing homes across Ireland, at a time when a spotlight has been shone on the sector as a result of the Covid-19 pandemic.
Nursing homes have been badly affected by the Covid-19 outbreak. As of early December, there had been 358 clusters – defined as a location where two or more cases have been confirmed – reported in nursing homes.
On 18 June, the secretary general of the Department of Health confirmed that almost one in five residents in Ireland’s nursing homes had been diagnosed with Covid-19.
PPE issues and social distancing
The documents released to TheJournal.ie show that many complaints were made in relation to infection control, social distancing and the supply of PPE soon after the arrival of Covid-19 in Ireland.
In one piece of correspondence sent to Hiqa in April, a person raised concerns over “infection prevention and control measures in [a] nursing home in relation to staff having access to PPE”.
Another piece of correspondence sent in the same month outlined that “staff claim appropriate PPE is not provided”.
One concerned person claimed there was “little PPE” being provided by the HSE in one instance, and that “many staff have tested positive and are not being replaced due to lack of support from HSE”.
Between March and September, over a dozen complaints were made regarding alleged social distancing issues in nursing homes.
In March, an anonymous person raised concerns regarding alleged “poor practice of social distancing and cleanliness concerns” in a nursing home. In May, one person alleged that a staff member at a nursing home was “not adhering to the rules of social distancing”.
Other concerns were raised with Hiqa throughout the year regarding issues with staff members.
In April a complaint was made about a number of staff members from one home allegedly wearing their uniforms in local supermarkets after work. The complainant was concerned about potential “cross-infection”.
Self isolation
People must self-isolate when they have symptoms of Covid-19, while they wait for a test appointment and results and if they have had a positive test result for the virus.
Anyone who has been identified as a close contact, but does not have Covid-19 symptoms, does not have to self-isolate but does have to restrict their movements.
The difference between self-isolating and restricting movements can be read here. Most people travelling to Ireland from abroad are asked to restrict their movements for 14 days on arrival. This includes Irish citizens returning home, as well as people with no symptoms. There are some exemptions to this, which can be read here.
Throughout the pages of correspondence to Hiqa, many concerns were raised regarding issues around staff and resident isolation, or the lack thereof.
In March, one complainant claimed that a staff member in one nursing home had returned from Spain, where the virus has struck particularly badly, went back to work “without any quarantine”.
Similarly in July, another person raised concerned that a senior staff member at one home had allegedly “been abroad and had not self-isolated in line with government guidelines”.
Another person claimed that staff in a particular nursing home “who had tested positive” but had no symptoms had been “requested to continue to work instead of self-isolating”.
In relation to residents, one concerned person alleged that a nursing home had admitted residents who had “returned from abroad without any quarantine”.
Visitation issues
While dozens of concerns were raised regarding the lack of adherence to Covid-19 guidelines, many other people expressed concern about the impact of visiting restrictions on residents.
On 6 March, Nursing Homes Ireland introduced strict new visitor restrictions asking people to only attend homes in “urgent circumstances”. Visiting of nursing homes was again allowed under certain conditions from 15 June, as Ireland entered Phase Two of the easing of Covid-19 restrictions.
However, under Level 3 restrictions, visits were suspended again, aside from critical and compassionate circumstances.
Several complaints were made about the isolation of residents after visiting bans were imposed.
In March, one person raised concerns that poor phone coverage at the nursing home could lead to “further isolation” of the residents.
Another person, in May, expressed concerns for a resident’s mental health “due to visit restrictions causing social isolation”.
In the same month, one person told Hiqa of their concerns about the visitation ban “impacting on residents’ quality of life, interaction with families, social isolation and loneliness”.
Some people also contacted Hiqa raising concerns over the well-being of residents during the visitation ban periods.
In March, one person alleged that a resident was being “neglected by staff” and was “being left in bed and missing their meals”.
Another person, in April, complained that there was alleged “poor communication” from a nursing home provider with families regarding their relative who had tested positive for Covid-19.
New guidelines for nursing homes and other care facilities came into effect from 7 December, whereby operators were advised that residents should be allowed one visit per week.
Other complaints
Over the course of 2020, Hiqa was contacted dozens of times with other non-Covid concerns.
In May, one person raised concerns with Hiqa over the quality of care within one nursing home, particularly regarding “management of falls, medical treatment, bruising and communication with family”.
In September, another person raised concerns about “the safeguarding of residents and the management of an allegation of abuse”.
One person contacted Hiqa in June as they were concerned that a report of physical abuse may not have been reported to the watchdog.
A number of allegations were made throughout the year in relation to staff members at nursing homes.
An anonymous person, in March, expressed concern about a staff member allegedly “smoking cannabis” on the grounds of a centre.
In the same month, another allegation was made about staff in a nursing home “being rough when caring for residents” and “derogatory comments being made by staff about residents”.
In July, one person raised concerns about “safeguarding of residents, particularly during intimate personal care”.
Hiqa response
Hiqa does not have a remit to investigate individual complaints. However, all unsolicited information, which can be received from anyone concerned about a centre, is used to inform the watchdog’s monitoring of each residential centre.
Hiqa monitors and inspects designated centres for older people, such as nursing homes, against regulation and standards.
“The aim of the Health Information and Quality Authority is to advance high-quality and safe care for people accessing health and social care services in Ireland,” a spokesperson for Hiqa said in a statement to TheJournal.ie.
“Where Hiqa has concerns related to the safety of residents and the quality of care that they are receiving, providers are required to take immediate action to address their,” they said.
The spokesperson said Hiqa inspectors follow up with providers to “ensure that the actions are being implemented and are resulting in improvements for residents”.
“Where there are risks to the safety of residents or where the provider has failed to address areas of concern repeatedly, Hiqa can take escalated action, up to and including court action to cancel the registration of the centre,” they said.
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You couldn’t make it up. The rich are now buying nursing homes and land to build one. There seems to be a nursing home on most corners nowdays have no problem with that whatsoever. But please pay the staff that are doing the hard work a decent wage. This €10 euro an hour for the work they do has to stop. Anyway thats my opinion.
@Paul Gorry: I couldn’t agree more. Well said
@Paul Gorry: Couldn’t agree more. We have an ageing population with an ever increasing life expectancy due to breakthroughs in science and medicine. (Didn’t they say on the news that 2021′s first born could look forward to a possible lifespan of 105!?) Unfortunately business investors see potential minefields in this phenomenon.
Caring for the elderly and vulnerable in a professional capacity is a skilled and stressful occupation;yet commands an insulting and inadequate wage.
@Paul Gorry: i agree, my mum is in a nursing home and staff must be paid more. At one time the chair lift was out of order and residents had to be carried up stairs or left in their rooms. They all kept working during pandemic when they would have got same wages on covid payment. Truly grateful for them all.
Personally i support the gardai!
@Billy Davies: Garda lives matter
@Billy Davies: 100% agree
Well to be fair smoking cannabis is the least of their worries,old people should be treated with respect not like bags of old compost to be disposed of at the whim of penpushing greedy beaurocrats or private entrepreneurs..
About time that the wealthy owners of these “ businesses “ are held to account. For years they were just cash cows and wonderful staff were paid minimum wage and expected to pay for their uniforms. Care to the owners never cut into their profits. Buildings so badly designed that we saw elderly having to talk through windows to loved ones. Why can mini conservatory sitting areas in sun light not be mandatory for each room. Of course ! It would eat into the profits. Some rooms are little more than prison cells built to maximise profits. Root and branch clean out need to sort out this “industry “
@Dave Phelan: Jeez Dave, sun room in every room. The last thing most residents need is to look longingly out a window or just seeing the weather. A high enough percentage of residents are no left in their rooms during daytime hours for their own safety and are usually seated in congregated areas to be monitored, I assmume social distancing is a nightmare because it makes supervision of residents more difficult. Immobile or fragile residents are usually only up for a few hours before returning to bed to protect pressure areas. Regarding costs. Insurance is beyond extortionate in nursing homes, I have never seen a claim for someone falling yet the insurance premiums would exceed a taoiseach’s salary. Mind you I agree they need to be controlled better to avoid being used as money cows
@Pat Ryan: horrified that you dismiss the importance of daylight. Summer the odd days some can get out however winter sunshine requires sun rooms. Circling the wagons around a tv with no remote control all day is torture. Activities are haphazard at best. Very very sadly I speak from personal experiences and have seen “new” buildings being totally unfit for pleasant living and are simply cells
@Dave Phelan: Horrified?? I was referring mainly to those who cannot tell night from day. Monday from any other day. Those that only know Sundays because mass is on or a visitor or family may visit or not. Those that couldn’t give a toss for being giving the honour of wasting away to the passing of time or locked in a time once new to them and long hence passed. Or do you forget with your blinkers that they do exist. Ive f@ing worked enough and seen enough of them to see their existence and no bloody sun room will take away their plight
@Pat Ryan: to a certain extent we are on the same page. However the appalling lack of proper design in favour of boxing in cells to keep inmates( patients) . I didn’t say windows ! I said sun room . A double sliding door to a small sitting out area off each room would bring sunshine into the lives of those who are confined in box rooms. Your dismissive way of talking about the elderly in these buildings is very confusing!
@Dave Phelan: You’re looking at one aspect without either understanding or awareness of the factors associated with that aspect. Fire safety precautions would be severely inhibited by each room having a sliding door. Monitoring residents would be a nightmare for overworked staff and the answer is not employing more staff to sit in each room. Do you realise the amount of current procedures that are in current use to monitor and restrict movements of wandering or confused patients and then give them multiple access points to leave the unit. Huge safeguarding issue there.
@Dave Phelan: These are not issues in most middle eastern countries where they get more sun than us, because they care for their elderly at home. I understand that nursing home are not appealing for many reasons, but mainly because if there were only nursing homes for those that actually need them there would be a lot less of them.
In fairness to the nursing home staff, one of the unit managers told me when I was in that about 70% of the residents don’t understand / remember social distancing. The other 30% would be lost without their wander around and visiting other residents.
The same unit manager was also Receptionist & Kitchen Porter on the day due to staff shortages due to Covid.
I despise all of these so called nursing homes that squeeze the last bit of dignity from a person while emptying their and their families bank accounts
Trying to blame the HSE for a shortfall in staffing and PPE simply because they won’t pay staff properly and wouldn’t spend the money on the PPE.
For sure on this one and again.
Its an Irish pandemic…most other societies look after their elderly rather than ship them off into a “nursing home “. They are for people who require fulltime nursing care. It is their home so social distancing isn’t an issue or shouldn’t be. There is little turnover of residence so mixing with eachother should be safe enough. For the weekly price of € 1200 a bed, the owners should be able to provide suitable PPE and trained tested staff to support the residents.
@vanc: exactly, why are these private nursing homes blaming the HSE, they are a business so their responsibility.
1000 euro a week to stay
10 euro an hour for staff
Residents eat like sparrows so money is Not going on Food..Shameful Greedy Partisans
@Larry Rawson: Parsimonious owners
In trying to find a good nursing home for my parents recently it was so obvious most homes were staffed to the minimum with poor investment in services and multiple additional fees….If it’s that apparent how poor this sector is being managed to normal people what does it look like to a professional working in this area and why is there no accountability? It sad people have such limited choices….
Look at the heading, isolation or distancing, what do you want?
have your say