Denis O'Donovan (Fianna Fail)
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I thank Senator Colm Burke for allowing me to speak first. This matter concerns Cara House, Market Street, Skibbereen, which is run by the Skibbereen Geriatric Society. Currently, there are 12 residents in the home and there is major concern that the home has been deemed to close on Friday of next week. There is concern and worry about where people will go. Most of these people are in their 80s; some are in their 90s. As far as they are concerned, Cara House has become their home. These people are old and vulnerable and their home is their castle. They are frightened and concerned about where they will be moved to. There are different rumours, including that HIQA has put the gun to the head of the Skibbereen Geriatric Society and demanded the closure of the home. There is another story that some of them will be transferred to Cork city, which is 60 miles from where some residents come from. I would like the fears and concerns to be addressed. Everyone in Cara House, which I know for many years, is a citizen of the State and it is unnecessary and unfair that they are stressed and that their families are worried and concerned about where they might be shifted to.

They are stressed and their families are worried and concerned about where they might be moved. This is unfair and unreasonable. I hope the Minister of State will clarify that an extension can be given through HIQA, the HSE or the geriatric society that runs the home to find suitable alternative accommodation. I have inquired through the HSE and no beds are available in the local community hospital in Skibbereen or in Dunmanway or Schull, while the privately run nursing homes in the area are full. The HSE is not stating this publicly, but its officials will admit that if they have to accommodate the people concerned, they will face logistical difficulties.

I hope the Minister of State will allay fears locally. I have said to those who have contacted me that the elderly people concerned should not worry because they will not put on the streets, but they are fearful about where they will be transferred. It is rumoured that they may be moved to St. Finbarr's Hospital in Cork, which would be a major inconvenience for them and their families. I hope the Minister of State will understand the motivation behind this debate and I do not raise such issues lightly. There is concern and worry, particularly among the elderly patients, some of whom are in their 80s and 90s. They are mentally active enough to understand what is happening and deeply concerned that they will be moved again. They experienced significant trauma and change when they moved from their own homes to this nursing home. None of them can return to his or her home. Cara House has provided an excellent service in the Skibbereen area. The staff are doing wonderful work and the patients are happy there. I wonder, therefore, why this is happening, who is driving the change and what is the current position. It is most important that when I relay the Minister of State's reply she reassure those affected directly that there is light at the end of the tunnel, that there is a way out of this and that the transfers will be made in a dignified and orderly fashion and with respect for the elderly people involved.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Senator for tabling this matter. Clearly, the shortage of long-stay intensive care beds for people who are ageing is an issue. We need to face up to it and we are examining it is a serious manner.

Cara House, Skibbereen is a residential home for 12 elderly women. It is managed by Skibbereen Geriatric Society. I concur that people are doing their best with the best of intentions. They did a good job at a time the State was not doing it. The society is a company limited by guarantee, which provides residential care and other services for the elderly of Skibbereen and its environs. In December 2012 it applied to HIQA for the registration of Cara House, Market Street, Skibbereen, County Cork, as a designated centre under the Health Act 2007.

Since July 2009 HIQA has been responsible for the registration and inspection of all designated centres for older people. It needs to be satisfied that systems are in place in all designated centres which ensure the safety and welfare of all residents and staff are protected. Cara House, as a designated centre, catering for the long-term residential needs of older people, is subject to registration and inspection under the nursing homes regulatory framework. A registration inspection visit by HIQA raised concerns which included the level of dependency of a number of residents, medication management, staffing and the ability of the home to cater for the residents in its current format. An immediate concern in relation to the administration of medication was addressed in the interim by the association by providing nursing cover to administer medication in the home.

As a result of the concerns raised during the inspection, HIQA prepared a plan of action for the society to address. Following receipt of this plan, the society's representatives met to discuss the situation. The outcome of this meeting resulted in their withdrawing their application for registration. The society advised both HIQA and the HSE that it would close on 28 June. At this stage the overall priority is the residents' wishes and concerns, as the Senator will be aware. One resident has been relocated to a long-stay bed in Bantry, while two residents are in Bantry General Hospital. Discussions are under way with them with a view to identifying an appropriate placement. Nine residents remain at Cara House, eight of whom have been assessed as requiring long-term residential care.

The HSE is working with the residents and their families to find alternative accommodation. Discussions have been held on the options available to them as they work to find alternative accommodation. Each is being supported in completing the application for financial support under the nursing homes support scheme. While all of the residents have identified a preference for a placement in Skibbereen - as the Senator pointed out, this has been their chosen area of residence for a long time - they have been advised that it is extremely unlikely that this number of beds will become available within the timeframe and second preferences have been discussed with them. All residents can be accommodated within the timeframe in at least the facility they have identified as their second preference. They have been further advised that a transfer back to either the community hospital or the private nursing home in Skibbereen could be requested and that they would receive the next available suitable bed. The remaining resident was not deemed to be in need of a continuing care placement and a package of care is being arranged to support her relocation to an apartment in Skibbereen.

Denis O'Donovan (Fianna Fail)
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I thank the Minister of State for her response. To some extent, she has cleared the air because all sorts of rumours were circulating about public meetings and so on. The issue was aired on local radio because the geriatric society, faced with the gauntlet of trying to comply with HIQA's request, decided to run before the storm, but the deadline of 28 June is tight. There is no fire hazard in the home and €50,000 was collected from the public by voluntary organisations in the past few months to cover the cost of works there. It is a pity the home will be closed and I hope somebody in charge of the relocation will visit it. As of a week ago - I am not sure about the past few days - the families of the elderly patients had not received reassurance about their security of tenure. A reassurance to that effect from a senior HSE official would help them to overcome much of their anxiety. I hope they can live out the rest of their days with dignity and respect.

Kathleen Lynch (Cork North Central, Labour)
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We all hope for the same. I will relay the Senator's concerns to the relevant HSE officials and I hope some reassurance can be provided. No one will be thrown onto the side of the street. At this stage of their lives, I will ensure the dignity they deserve is delivered.