Residents of five nursing homes in Offaly contracted COVID-19

Cases of COVID-19 have been confirmed in five nursing homes in Offaly, new figures have shown.

The data is included in a recently-published report by HIQA: 'The impact of COVID-19 on nursing homes in Ireland'.

The report details the findings of recent inspections and HIQA’s interaction with nursing homes throughout the outbreak, and describes the experiences of residents, their relatives and staff.

It found that by the end of June, over half (51%) of nursing homes had reported a confirmed case or cases of COVID-19, while 9% of centres had reported a suspected case. Forty per cent of centres had reported no outbreak.

Initially HIQA made the decision on March 13 to temporarily suspend all routine inspections and introduced a process by which nursing homes were asked to provide information on how they were meeting a new framework for contingency planning and preparedness for COVID-19.

This “self assessment” process was then validated through interviews with nursing home management by HIQA inspectors.

However, the report says the Chief Inspector of HIQA had some concerns around a number of nursing homes and how the providers were managing outbreaks of COVID-19 in those centres. Therefore, risk inspections resumed in late May 2020 and focused primarily on those centres that had reported confirmed cases of COVID-19.

Since May 27, a total of 44 such risk inspections had taken place. None of the nursing homes inspected were found to be fully compliant with the regulations inspected against. Five nursing homes were found to be mostly compliant, where inspectors assessed compliance with the regulations as being either compliant or substantially compliant.

The remaining 39 nursing homes were judged to be not compliant with one or more regulation assessed.

The report noted “it is a concern that 11 nursing homes were found to be not compliant with at least one in three of the regulations inspected.”

An emergency closure order of one nursing home was sought and granted by a District Court in late May, due to HIQA's concerns “regarding the management and systems in place to keep residents safe”.

Key findings from these inspections included that governance and management structures in some centres were still not sufficient to withstand an initial or even a second wave of an outbreak.

Baseline staffing levels were found to not have been increased, even in those centres where there had been significant outbreaks; where additional staffing resources had been provided they were removed as soon as was feasible.

Infection prevention and control knowledge and competence commensurate with a pandemic was not available in centres, leading to an ongoing reliance on public health and HSE resources.

Centres had access to PPE and other key consumables earlier in the pandemic, but there was confusion with regard to who was responsible for ongoing supply of such equipment.

HIQA’s Chief Inspector of Social Services and Director of Regulation, Mary Dunnion, said: “COVID-19 has brought into sharp focus the need for reform of current models of care for older people in Ireland. The continued use of multi-occupancy rooms and outmoded premises in some nursing homes undoubtedly created challenges in containing the spread of infection. We must look to complementary models of care, such as homecare and assisted living, and ensure that there is improved clinical oversight in all nursing homes.

“Furthermore, the regulations governing nursing homes are outdated and must be revised to make them fit for purpose, particularly as regards governance, staffing numbers, skill-mix, and infection prevention and control. HIQA will continue to listen to the experiences of residents, relatives and staff to strive for safer, better care that focuses on the human-rights and individual needs of the person.”