Tuesday, 24 November 2020
Nithe i dtosach suíonna - Commencement Matters
This is my first time addressing the Minister in the House so I warmly welcome him here. I commend him on the outstanding job he is doing in health which, in fairness, is something that has been acknowledged by all sides of the House.
I am sure the Minister is familiar with the very sad situation that obtains at Oaklands nursing home in Listowel, which is about two miles from my home. It has made the headlines recently for all the wrong reasons, in particular the fact that 23 out of 24 patients proved to be Covid-positive and, as of this morning, we had six Covid-related deaths. Just now, as I was walking into the Chamber, I was informed that the number has risen to eight. I sympathise with the afflicted and with the families of the bereaved. It is a terrible time for them. The reason I tabled this question is to try to help them to get information. They are very reasonable people but there has been a communications deficit both regarding what is happening in Oaklands and what is happening in some of the other community care facilities around the county, including in the town of Kenmare, as you know well yourself, a Chathaoirligh.
The situation in Oaklands is disturbing insofar as there is plenty of evidence to show that HIQA had concerns about the facility for a substantial period.In its most recent unannounced visit during the summer, it found quite a number of deficiencies in the management, and a big list of improvements to be made was drawn up at that time. Unfortunately, we have no knowledge of what was taking place before the outbreak of the pandemic in Oaklands nursing home, but certain questions have to be raised. What was the follow through action on the issues flagged during the HIQA visits, and who supervised it? Either the facility was working appropriately and adequately or it was not.
I refer again to the issue of communications. The families involved, like all families, have suffered so much, and they have not been able to attend the funerals of their loved ones. The very least they need to know is what is happening there right now and what the immediate plans for the future of that facility are.
I will speak briefly on the other issue I wish to raise. As the Minister of State knows, patients from the nursing home have been dispersed to other community care facilities in the county. Latterly, and in the past few days in particular, this has given rise to widespread concern in all the other hubs involved in Kerry. I would like to know whether it is true that in places such as Kenmare there is an increased level of infection, either among the patients or the staff in the nursing homes there. Are there adequate staff rotation systems in place, for example, in Kenmare? What additional facilities does the Minister of State think should be provided to help homes like those in Kenmare to deal with the incursion that has been visited upon them as a result of the Oaklands situation? I am not trying to make any political capital out of this situation, and even though it is happening close to where I live, I have no real involvement in or knowledge of Oaklands nursing home. Like all the other facilities, it seemed to be working reasonably well, but this was all going on behind the scenes and we did not know about it. I look forward to hearing the Minister of State's response to the issues I have raised.
It is lovely to be back again in these beautiful surroundings. Every time I look up at those beautiful Waterford Crystal chandeliers, I think how very lucky we are to be in such an opulent room.
I want to thank the Senator for raising this very important issue. Every person who is supported in older person's services is entitled to expect and receive supports of the highest standard. Quality care and patient safety is a priority, and our continued focus is, and will always be, to deliver safe, high-quality services.
Nursing home providers are ultimately responsible for the safe care of their residents. Since 2009, HIQA has been the statutory independent regulator in place for the nursing home sector, whether homes are HSE-managed or private nursing homes. As the Senators will be aware, there are currently 585 nursing homes in Ireland, 80% of which are privately owned and 20% of which are run by the HSE. The authority, established under the Health Act 2007, has significant and wide-ranging powers, up to and including, withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider. This responsibility is underpinned by a comprehensive quality framework comprising registration regulations, care and welfare regulations and national quality standards. In discharging its duties, HIQA determines, through the examination of all information available to it, including site inspections, whether a nursing home meets the regulations in order to achieve and maintain its registration status. Should a nursing home be deemed to be non-compliant with the regulations and the national quality standards, it may either fail to achieve, or lose, its registration status. In addition, the chief inspector has wide discretion in deciding whether to impose conditions of registration on nursing homes. As the Senator will appreciate, it is not appropriate to speak about individual cases, however, I can assure the House that the HSE is engaging directly with the nursing home in question, and has been since early November 2020.Last week, arising from concerns about the operation and management of the nursing home, HIQA's chief inspector initiated court proceedings under the Health Act 2007 to cancel the registration of the nursing home. In accordance with the legal process, the HSE has formally taken charge of the nursing home to carry on its operation until alternative arrangements for the residents can be put in place. The HSE is undertaking various assessments of the situation and is considering its options in order to ensure the safety and care of the residents in question. The situation is evolving rapidly, as the Senator has noted, and involves a complex set of circumstances.
I am aware of how distressing a time this is for residents and families of those who have passed away as a result of Covid-19. I express my condolences to the families of those who have lost their lives in this nursing home. The Senator said he had been informed of two more deaths today so that brings to eight the number of older people who have lost their lives in that home. I sincerely sympathise with all their families. My officials will continue to engage with the HSE on this matter and I will ask the HSE to ensure it communicates appropriately with residents and families. Communication is one of the key issues here.
Unfortunately, I am not in a position to answer questions about various individual nursing homes the Senator has raised or the transfer of patients. However, he may rest assured that I will raise these issues and concerns immediately with the Department of Health and the HSE to try to get some understanding of exactly what the situation is.
I welcome the Minister of State's answer. I acknowledge that she cannot talk about particular instances and I am reluctant to bring up an individual case. I normally would not do so but as the Minister of State said, this is a rapidly evolving situation. There is concern about it as Listowel has consistently had very high rates of Covid per capitaand was one of the highest local electoral areas, LEAs, in the country for a period. It is worrying for us and now it is worrying for other sectors and parts of Kerry as well. What I take from the Minister of State's response is her commitment that the HSE will communicate with the families. I join with her in sympathising with the bereaved and I wish them well at this very difficult time.
I thank the Senator for raising this issue in such a sensitive manner because it is very difficult for the many families that may be listening in, who are very concerned about their loved ones receiving care in nursing homes throughout the country. I am sure the House will understand my reluctance to speak in any great detail about the specifics of one particular nursing home. Since the onset of this pandemic, HIQA has put in place a quality assessment process, whereby all designated residential centres are formally contacted on a regular basis by an inspector or social services to assess how they are coping, the welfare of the residents, any concerns they have and any deficits identified in their ability to sustain a safe, high quality service. As the regulator for the nursing home sector, HIQA has completed a risk assessment of all nursing homes. In addition, a HIQA Covid-19 assurance framework was published on 28 September to support social care services in order to ensure effective infection prevention and control practices are in place.
The central focus of the response to Covid-19 has been controlling the spread of the virus insofar as possible. Sustained communication and interagency co-operation also remains central to the response to Covid-19. A package of supports was put in place, which has been of critical importance. Those supports include guidance, PPE, staffing, serial testing of all staff on a fortnightly basis since June, infection prevention and control training, and financial supports for the nursing home sector, both public and private. In addition, public health outbreak control teams and multidisciplinary clinical supports are in place at CHO level, with 23 Covid-19 response teams.
Unfortunately, this information does not answer the Senator's specific questions and I cannot speak specifically about one particular nursing home. However, I assure him that the HSE has been onsite from a very early stage and is working constructively. I will make sure of the commitment I gave the Senator today that the families will be communicated with. As I have said, I will raise this matter immediately on my return to the Department.