The HSE are taking over a north Kerry nursing home and making alternative arrangements for its elderly residents, on foot of an order sought at short notice at Listowel District Court yesterday.
The order centring on Oakland’s Nursing Home, Listowel became effective from 5pm on Thursday evening.
The application by the chief inspector of Social Services and HIQA further succeeded in cancelling the registration of the company operating Oaklands, Bolden (Nursing) Ltd as the registered provider of a nursing home.
The HSE was a notice party, in the proceedings, barrister for HIQA Brian Gageby informed the court.
The HSE team, who entered the nursing home on Nov 4th after residents tested positive for Covid-19, “found a centre in chaos”, deputy chief inspector Social Services and HIQA, Susan Cliff said.
There had already been “a high level of concern” already and this year there had been seven inspections.
Two visits “maximum” was the normal rate per year for nursing homes, Ms Cliff told Judge David Waters.
There had been concerns that management structure was insufficient; and there was concern the culture in the centre needed to become “more person centred”, she said.
Those concerns were heightened because of Covid-19 .
When inspectors visited in September 30 last they again found a poor culture of care, and there were very “specific issues” she said.
There were no empty rooms brought together for patients who might test positive for Covid-19, she said.
“All staff were in contact with all patients,” she also said.
There was no proper supervision of care of residents and there were concerns surrounding meal times.
Domestic cleaning products were still in use, and not those for Covid-19
Nutrition was very important for the elderly. An inspector noticed how a carer entered a room with a meal and brought back a full plate of food from the patient’s room. The full plate of food was discarded in front of a nurse and the nurse never questioned if the man ate the food or wanted something else, Ms Cliff outlined.
Poor nutrition was a heightened risk for Covid-19, she said.
On November 4th last, after receiving information that a number of residents tested had positive, the HSE “immediately” sent a team.
“They found a centre in chaos,” Ms Cliff said.
Residents were “wandering unsupervised” and those who tested positive were mingling with non-positive residents.
Some staff had tested positive and were a symptomatic and residents were not notified; Residents with “classic” Covid-19 symptoms – coughs and temperatures – were not being monitored.
“Alarm bells should have been firing off in this centre and it didn’t happen,” Ms Cliff said.
Speaking on Morning Ireland, HSE CEO Paul Reid admitted it was a “very distressing time” for the residents of Oaklands Nursing Home in Listowel and their families.
“I do want to reassure them; we have taken over the facility late yesterday evening and are doing everything that needs to be done in terms of care and resourcing as well as hygiene and what needs to be done to protect those residents and support that nursing home.”
A judge yesterday said there was “poor clinical governance”, poor infection control measures and was satisfied there was a “serious risk to life and welfare” found in the Oaklands Nursing Home.
Mr Reid said there were up to10 nursing homes that were “on high alert” nationwide but said outbreaks are being identified much quicker due to serial testing.
“There are between five and 10 that we would class as in the red, under high alert, where we have a high level of intensive supports. It has held much better than the first wave and that is due to the serial testing we are doing. The serial testing is giving us an early warning of nursing homes that are at risk.
“There are 100 we would have under close watch, out of the 2,000 or so such settings across the country. It is a small percentage overall but they are high risk and about 10 of them are under much higher watch,” Mr Reid said.
Centre of chaos
There were “no restrictions or checks on people coming or going” to the centre. When inspectors entered the centre in on 4th November, there were no checks.
“It was a centre in chaos on that day,” she replied to Judge Waters .
There were concerns about medication management, the deputy chief inspector outlined.
The IT system was out of order and there was nothing to back it up. End of life medication prescriptions were out of date, she said.
The result of this would be that patients may not get the medication required to make them comfortable in their last days, she explained.
The respondent, Bolden Ltd, was not represented in court. However there was consent to the application, the court also heard.
Judge Waters said given the poor clinical governance and the poor infection control measures he was satisfied there was “serious risk to life and welfare of persons in the centre”.
He granted the orders under Sections 59 and 64 of the Health Act 2007.
Source: Irish News