Thursday, 13 January 2011
Adjournment Debate (Resumed)
I welcome the opportunity to raise this important issue for south County Tipperary on the Adjournment. I am glad that my colleague, the Minister of State, Deputy Mansergh, is present.
I am deeply concerned about the HSE's plans for the Cluain Arann welfare home in Tipperary town. This home caters for 19 individuals who the HSE is planning to relocate without appropriate consultation with residents, their families or the wider community, which has supported and facilitated the delivery of services in Cluain Arann and made it an appropriate setting. "Welfare home" is probably the wrong name for it. It is a caring, friendly and warm centre. I have often met its residents around the town and in neighbouring villages. One resident who I met in Donohill but whose name eludes me came to play us a few tunes on an accordion on Dan Breen Sunday. The centre's residents are mainly in reasonable health, but are uneasy about staying at home because of a lack of facilities. They have been residents at Cluain Arann for a number of years.
There is no local area manager for Tipperary town. As a result of the recent redundancy scheme, some local managers have left. I pay tribute to two recent managers, Mr. Seamus Moore and Mr. Chris Monahan, both of whom I have interacted with and who were in negotiations with the HSE before leaving. I appeal to the Minister, Deputy Mary Harney, to ensure a manager is appointed. I have failed to make contact with Ms Breda Kavanagh. I have spoken with Mr. Monahan, but there is no clarity. All of this is causing the residents unease. I understand staff were consulted and told there would be no staff lay-offs, so I wonder what will happen to them.
If a model is not broken, why try to fix it? Cluain Arann is a wonderful facility adjacent to another HSE facility. Residents are happy to live out their lives in its environment. They are privileged to be residents of the home and finding somewhere even remotely like it to relocate them will be difficult. They have made friends, so their relocation will be difficult on them.
The HSE is conveniently using the quality guidelines of the Health Information and Quality Authority, HIQA, as an excuse to close the facility, but where were those guidelines when we were being told last week of 500 patients on trolleys throughout the country? Where are they when there is bedlam in accident and emergency units at night? Hiding behind HIQA when it suits the HSE is farcical.
The Cluain Arann facility should be used as a role model for other communities. The old adage is appropriate, namely, where Tipperary leads, Ireland follows. I am glad the Minister is present.
As with the working time directive in respect of doctors, we have quoted HIQA's guidelines. It is what we always hear when somewhere is to be closed. I do not accept this jargon and do not accept that we must obey these guidelines. They are used very conveniently. I met HIQA as one of a number of backbenchers and asked the same questions but the HIQA representatives shrugged me off; they were not interested.
How unsafe is it for patients to be on trolleys? There are hundreds of them around the country. Those involved are, however, well cared for and able to look after themselves to a great extent; they do not need specialised care. There is no staff shortage but the staff have been told they will be redeployed but we do not know where. I hope it is not like Cashel Hospital, which closed years ago, yet some of the staff are still there.
This is unnecessary. This welfare home should be a model and I ask the Minister to tell us who is in charge in that region of the HSE. The Minister of State now accepts there was no consultation in St. Michael's Hospital last year, despite what we were told by the HSE officials. There was consultation in this instance - to be fair the manager told me that - but we should be copying this model to put in place low cost facilities around the country.
Cluain Arann Welfare Home provides residential services to people over 65, with a range of dependency needs. Many of these residents are capable of living independently and require minimal assistance in a home-from-home environment. The management of Cluain Arann Welfare Home consists of a director of nursing and here are 7.5 full-time posts, with all staff reporting to the director, providing 16 hours nursing care per week.
It is located in Tipperary town, on the same site as Cluain Arann community nursing unit, which shares some facilities and is integrated into the same building. While both units are managed independently, they share the entrance and reception area, a large kitchen, dining room, sitting room, physiotherapy department, sluice room, cleaning room, laundry, records room and staff facilities.
The welfare home has 35 residential beds, 19 of which are currently occupied. These are configured into 20 single bedrooms with wash-hand basins and five three-bedded rooms with shared wash-hand basins and toilet facilities. There are three bathrooms, two with showers, and one with a bath. In addition there are four separate toilet facilities for residents' use. Each room has adequate storage space with a lockable wardrobe available in all bedrooms. The goal is to maintain an independent style of living with appropriate supports provided.
As the Deputy is aware, the care and welfare regulations for designated centres for older people currently require 24 hour nursing care. The home had been inspected in September 2010 by the Health Information and Quality Authority and one of the issues highlighted was the lack of 24 hour nursing care. In this context the HSE felt that it was necessary to close the home and provide the residents with alternative appropriate residential care.
The Department has recently commenced a review of the care and welfare regulations and one of this issues being considered is the level of nursing care that would be appropriate in designated centres. In anticipation of the outcome of this review, the HSE is reconsidering the options that may become available. The HSE will engage with HIQA to see what arrangements can be put place to enable the home to meet the regulatory requirements and remain open.
Convalescent, respite, and palliative care will continue to be provided at Cluain Arann. There is a ten bed unit on the same site which, as I stated earlier, currently shares many facilities with the welfare home. I acknowledge this may have caused anxiety for residents and their families but at all times the HSE was acting to provide the most appropriate care possible for the residents.