ALMOST 140 concerns were raised about nursing homes in Cork last year, during a time of huge concern for residents and staff amid the Covid-19 pandemic, The Echo can reveal.
Nursing homes across Ireland have been at the forefront of the battle against Covid over the past two years or so, attempting to keep the older and more at-risk population safe from the virus. Nursing homes across Cork and the country have had to contend with wave after wave of Covid-19, outbreaks inside their very walls, and a decimated workforce due to widespread infection.
Nursing Homes Ireland chief executive Tadhg Daly told The Echo that the virus, which particularly threatened those in nursing homes, “presented huge pressures for nursing home management and staff”.
Information obtained under the Freedom of Information Act revealed that some 136 concerns were lodged with the Health Information and Quality Authority (Hiqa) in relation to nursing homes across Cork last year.
During the same period, two notes complimenting nursing homes in Cork were also received by Hiqa.
While the names of the nursing homes were not provided and 36 of the concerns were redacted, documents provided by Hiqa contain details regarding the concerns raised by members of the public in relation to nursing homes in the region.
Almost 30 of the concerns related to poor communication by nursing homes while a similar number related to poor governance and management.
More than 20 concerns were raised in relation to the safeguarding of nursing home residents.
During the same period, almost 20 concerns alleged there were poor infection control and prevention measures at some nursing homes, while around 17 highlighted concerns with poor staffing levels or staff turnover.
Meanwhile, 13 people raised concerns in relation to the lack of visiting restrictions in line with Health Protection Surveillance Centre (HSPC) guidelines.
Eight people raised concerns about the quality of end-of-life care at some nursing homes in Cork, while three more highlighted issues with the Covid-19 mortality rate.
Documents provided by Hiqa show that one complainant raised concerns about the safeguarding of residents and “the management of allegations of abuse”.
Hiqa’s documents also revealed that one complainant was “concerned about inadequate communication and poor management of a Covid-19 outbreak and requesting Hiqa to undertake an investigation”.
Another was concerned “about infection prevention and control measures and staff working cross-site during a Covid-19 outbreak”.
Another alleged that there was a “breach of Covid-19 visitation policies” at one nursing home.
One complainant alleged that there was poor quality of care in relation to Covid-19 mortality rates and poor communication with families on this issue at one nursing home.
Another alleged that there was a “miscommunication” in relation to a Covid-19 diagnosis at one nursing home.
In a statement to The Echo, a Hiqa spokesperson said: “All unsolicited information received is acknowledged, logged, and examined by Hiqa.
“If the information relates to a service within Hiqa’s remit, it is reviewed by an inspector to establish if the information received indicates a risk to the safety, effectiveness, and management of the service, and the day-to-day care the resident or patient receives.”
If Hiqa considers that a nursing home may not be compliant with regulations or national standards, the watchdog has a number of responses available to it, the spokesperson explained.
Hiqa can “respond by asking the service provider to submit additional information on the issue, requesting a plan from the service provider outlining how the issue will be investigated and addressed, using the information on inspection, or by carrying out an unannounced inspection to assess the quality and safety of the care being provided in the service”.
Where the information indicates that people may be at immediate risk, Hiqa will use its full legal powers and report the incident, where appropriate, to gardaí, Tusla, or the HSE’s adult safeguarding team, the spokesperson added.
“Hiqa also receives information about services that are not within our remit,” they said.
“When this happens we direct the person to the organisation best placed to address the complaint — the provider of the service, the Ombudsman or the Ombudsman for Children.
“All immediate and/or serious safeguarding concerns are referred directly to either Tusla, the HSE’s adult safeguarding team or the Mental Health Commission.”
There are 67 HSE, private, and voluntary nursing homes across Cork, providing 24/7 care to around 3,500 people.
Nursing Homes Ireland stated that while Hiqa accepts “unsolicited information” regarding nursing home care, “the submission of such does not necessarily constitute a complaint”.
In 2017, Hiqa analysis revealed that 2% of unsolicited information submitted to the watchdog led to targeted inspections, while 41% led to engagement with the provider. No concerns were referred to other authorities for investigation.
Speaking to The Echo, Mr Daly said: “Covid-19 presented a pandemic never previously encountered within our health services and wider society, and nursing homes were those on the frontline, managing a virulent virus that threatened the lives of residents and presented huge pressures for nursing home management and staff.
“The nursing home sector is arguably the most heavily regulated element of the Irish health sector,” he added.
“Nursing homes are subject to a robust and transparent regulation and inspection process, as they should be.
“Any person with a concern or complaint is required to initially bring it to the attention of the nursing home.
“The nursing home complaints procedure is required by regulation to be accessible, effective and displayed prominently within the nursing home.”
Mr Daly explained that all complaints must be investigated promptly and fully, and must be properly recorded by the nursing home. A complainant must not be adversely affected, he explained.
“A failure to resolve [the matter] with the nursing home means the complainant then has recourse to escalate it to the Office of the Ombudsman for investigation,” he said.
“Hiqa risk assesses all the information it receives against the stringent national regulations and standards applied to nursing homes.
“If there is a risk to the health and welfare of a person receiving care, it can and does take further action, with powers of enforcement including imposition of conditions on the registration of registered providers and/or up to cancellation of registration.”