THE LACK OF statutory clinical oversight of care in private nursing homes is one of the greatest weaknesses exposed by Covid-19, the Oireachtas Special Committee on Covid-19 has said. 

In a report, published this evening, the committee recommends that the Department of Health “urgently reviews” clinical oversight and governance in privately run nursing homes. 

Deaths in nursing homes accounted for over 50% of all Covid-19 deaths. At the peak of the pandemic, nearly weekly reports of new clusters, outbreaks and deaths in Irish nursing homes were a major source of criticism for the government. 

“The committee is strongly of the opinion that we need to strengthen clinical oversight of individual nursing homes, both public and private, by requiring a designated medical officer be appointed to each nursing home,” committee chairman Michael McNamara said in a statement. 

The report also calls for the Department of Health, alongside the HSE and HIQA, to develop a plan to ensure staffing levels and infection control are able to cope with any second wave of Covid-19. 

Other recommendations include asking the Department of Health to ensure regulations are robust enough to protect nursing home residents, while the members of the committee also suggest that no patients are discharged from hospital to any nursing home which fails to meet infection control standards. 

The report also calls for adequate stocks of PPE to be provided to all nursing homes in the months ahead. 

“We know, for instance, that the discharge of patients from acute hospitals to nursing homes has been tightened up through testing and isolation procedures, which is welcome. However, the fact that the HSE still facilitates the placement of older persons in a nursing home with known infection control risks is, in the view of the Committee, indefensible. This practice must end,” McNamara said. 

McNamara said that the committee will come to a decision in September on whether a public inquiry is needed into the scale of cases and deaths in nursing homes. 

Reaction

This evening, Nursing Homes Ireland CEO Tadhg Daly welcomed the report’s findings. 

“The report correctly finds the public health authorities were slow to respond to the threat posed by Covid-19 in nursing homes and engagement undertaken with our sector was not substantial or fully collaborative in nature,” Daly said in a statement. 

Daly, in a lengthy statement, added:

Our sector continues to ask why nursing homes were not a bigger priority in the preparations for the pandemic, why guidance was so slow to come and the purpose of the regulator’s latest report when it would have been better to come during the height of the crisis.  We hope the Committee will also get to the bottom of HIQA’s role on NPHET, which failed to focus on nursing homes at the outset.

“Government must now lead in assessing the challenges that present in terms of ensuring the staffing skill-mix and complement is available to meet the health and social care needs of residents in nursing homes who have high-intensity, complex care needs,” Daly added. 

The Irish Nurses and Midwives Organisation (INMO) welcomed the report, backing the call for better staffing levels. 

“The Oireachtas committee is absolutely correct in its recommendation on staffing. For decades, staffing levels in the Irish health service have been based on historical levels,” said INMO General Secretary, Phil Ní Sheaghdha. 

“A ward would have staff based simply on what they have had previously, rather than patient needs. Whether we are facing a second wave or not, Ireland needs to set staffing levels based on evidence, not history,” she said. 

However, one member of the committee called the findings “too watery”. 

Bríd Smith, a People Before Profit TD, said the findings need to be stronger when the full report is published in September. 

“We need to examine the fact that 80% of our nursing home capacity is run by private for profit homes which are not equipped to provide medical treatment and couldn’t adequately retain staff,” she said.