The head of Nursing Homes Ireland (NHI) has accused Government authorities of leaving the nursing home sector and its residents “isolated” at the outbreak of Covid-19.
Tadhg Daly heavily criticised the State’s response to nursing homes as it grappled with clusters of the virus spreading through a number of residential facilities.
The chief executive of Nursing Homes Ireland told the special Oireachtas Covid-19 committee that the “dismay will live forever with us”.
Mr Daly gave evidence to the committee on Tuesday as it examines how NHI and the Health Information and Quality Authority (HIQA) managed the pandemic in care homes.
Covid-19 has presented the most seismic challenge for our health services and specifically for nursing homesTadhg Daly, NHI
Mr Daly said the sector was left “exasperated” as it needed a specific plan from the Government.
Outlining some of the challenges, Mr Daly said there was insufficient testing of residents and staff, a mass shortfall of personal protective equipment (PPE), aggressive recruitment of nursing home staff and discharges from acute hospitals to nursing homes without testing.
“The NTPF (National Treatment Purchase Fund), the authority responsible for the commissioning of nursing home care, fell silent as homes incurred considerable and responsible costs to manage the pandemic,” Mr Daly said.
“The Department of Health eventually intervened.
“Key State organisations left the nursing home sector and its residents isolated in those early days.
“Covid-19 has presented the most seismic challenge for our health services and specifically for nursing homes.”
Sage Advocacy executive director Mervyn Taylor told the committee that the impact of the outbreak has been “frightening” for many residents, and for those with dementia the arrival of people in full PPE was “terrifying”.
“Serious shortages of staff meant that there was little, if any, time to provide support to residents in facilities where many died,” Mr Taylor added.
“For families with relatives who were extremely ill or dying, the inability to visit or to even talk to their loved one by phone was a source of considerable distress and frustration.
“At the core of this issue is the fragmented nature of social care for older people.
“Home support services, such as they are, are not on a statutory basis, are not regulated and have no clear vision, other than the level of home care packages that can be provided in any one year.
“Care in nursing homes is on a statutory basis and is regulated, but it has an overly complex and ultimately dangerous architecture.”
Hiqa chief executive Phelim Quinn has said the HSE did not know much about the private nursing home sector.
Speaking at the afternoon session of the committee, he said: “Currently 80% of nursing homes are operated by private providers although funded through the nursing home support scheme. The HSE did not know this sector. As a consequence, the infrastructure required by the HSE to support the private sector was under-resourced and became increasingly challenged.
“The private residential care for older people has no form of clinical governance linked to the HSE and importantly this means there is no national clinical oversight of care being delivered to some of our most vulnerable citizens.”
Social Democrats TD Roisin Shortall expressed shock at Mr Quinn’s comments and said “this virus has exposed huge weaknesses in how we provide social care in this country”.
“Hiqa CEO Phelim Quinn drew attention to that fact that 80% of nursing homes are operated by private providers even though largely funded by the HSE… for him to say the HSE did not know this sector – that is a damning statement to make about our national health service,” she said.
Mr Quinn said the private nursing home sector faced challenges regarding timely testing and results, sustainable access to PPE and difficulties maintaining baseline staff numbers including senior nursing staff with expertise in infection control.
Mr Quinn said in recognition of the difficulties faced by the private nursing home sector, it implemented a number of interventions from March 5 asking the Department of Health for a more coordinated response.
“On the 18th of March, HIQA made a formal offer to the HSE to assist designated sectors,” he said. “This was in recognition of the fact that there is no established relationship between the HSE and the private sector.”
Mr Quinn said the quality of health and care services would be greatly improved by a review of the current regulatory framework and called for the introduction of an accountability framework.
Significant milestone today. First day with no reported #CoVid19 deaths since March 21st. This is a day of hope. We will prevail.— Leo Varadkar (@LeoVaradkar) May 25, 2020
On Monday, Ireland recorded no new Covid-19 deaths for the first time since March. The total number of Covid-19 related deaths is 1,606.
Taoiseach Leo Varadkar hailed the news as a “day of hope”.
The last day when no death was reported in Ireland was on March 21.
A further 59 cases of Covid-19 were confirmed, bringing the number to 24,698.