Seanad debates

Wednesday, 29 November 2006

Leas Cross Nursing Home Report: Statements

 

8:00 pm

Photo of Joe O'TooleJoe O'Toole (Independent)

These guys are too smart. Many Members were concerned about how the issue of the legal advice would be dealt addressed.

Patients are happy and content in most nursing homes. Recently, I visited a number of nursing homes for a number of reasons. I received a great lift when I sat beside a 90 year old woman from west Clare in the reception area of a nursing home in the midlands. I asked her how she had come to be in the nursing home. She replied that she had no family in Ireland, as her siblings were abroad, and she wanted to stay in a home where she would be looked after. I asked her why she selected the particular nursing home and she replied that she read about it in Woman's Way and it sounded like the kind of place she would like. She was absolutely compos mentis and she was looked after very well. I had called to this home to visit a person who had a high profile in the media until recently but, unfortunately, he is suffering from Alzheimer's disease. He did not recognise me but we had known each other very well over the years. He was well cared for and when I walked into the home, staff were hovering around to help him.

An increasing number of families have relations who need to be cared for in a nursing home because of their age and the family's need for space. Home supports are provided by the Department but I know three or four families that must look after, say, two spinster aunts who live independently but who can no longer look after themselves. The State provides each of them with supports but if they lived together and received the same support, it would take pressure off nursing homes. That is not rocket science. An average person examining systems, efficiencies and value for money would consider this and it should be examined in the budget. Groups of elderly people could be cared for together using the home help service and independent care groups.

Many care support groups and agencies are not subject to inspection or examination and staff employed by them are not subject to legal or security checks. I could outline two worrying cases of individuals who should not have been left on their own in the homes of elderly people. Even though the agency involved was reputable, it had not conducted a check because it was not required to do so. Staff employed by such agencies to provide home support should be registered centrally. For example, security clearances must be provided by those brought into schools as substitute teachers.

The inspectorate is a bad idea, although inspection is a good idea. It is not possible to establish an inspectorate qualified to deal with all the issues raised in the report. Nursing homes should be included in the remit of the local health and safety officer and he or she should be required to forward reports once or twice a year. Similarly, reports should be provided by the local fire officer and general practitioner clinic while a structure should be provided so that families and friends of nursing home patients can have an input into the inspection process. I have heard the arguments about on-the-spot inspections and unexpected inspections during the night and so on. However, no single office can inspect fire hazards as well as all other health and safety issues, the staff-patient ratio and the use of medication.

I would need reassurances that my loved ones are not being drugged up to their eyes, because that is the most important issue. I could live with the temperature being too high or low in the home or a few minor hiccups in the service provided, even though that should not happen. However, the greatest issue is the administration of drugs to those living in the nursing home and that cannot be covered by the inspectorate proposed by the Minister. Everybody is clamouring for it and the political commitment has been made but it is like a soundbite to get people off the Government's back and it is not a good idea. A multifaceted approach must be adopted so that all the issues involved are examined and the appropriate agent is given responsibility for them such as the local doctor, fire officer, health and safety officer, dietician or other medical staff. Medication checks should be conducted and I would be reassured by that. The family and friends of patients should also have a structured input.

The publication of the report in the main hall or reception was a little freaky. While I can understand the argument for doing so, I do not know what that can tell us. It should have been made available to all those who were looking after patients in the home. I did not understand recently why, when four or five nursing homes were suspended, they could continue to operate even though they were not permitted to take in more patients. If they could not take in patients, the issue was probably the staff-patient ratio, but that was not stated. I would like to know if that was the case because it would concern me less than a problem of a more fundamental nature, that is, the care of the residents. I do not know whether publishing these reports will provide the information for which we are looking. This is a matter of trust and confidence and giving people information to make judgment calls in the knowledge that so-called official Ireland has examined the situation and reached certain conclusions.

In other major scandals, such as at Artane and Letterfrack, part of the problem was due to the wrong inspection routine. Inspectors went in and got tea and buns in the parlours, but that did no good. A modern version of the same could occur in this instance if it were always the same inspector visiting. Let us spread the job of inspection to the qualified people, namely, a health inspector, a dietician, a local general practitioner, a fire officer, a health and safety official and, every now and then, someone with a qualification in geriatrics.

There will always be problems. This is not a political issue and we must deal with it in a straightforward and efficient way that provides value for money, restores trust and confidence in the system and looks after our future because all of us will be involved.

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