Gerald Nash (Louth, Labour)
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1316. To ask the Minister for Health the reports on deaths and Covid-19 outbreaks HIQA requires from nursing home providers; and if he will make a statement on the matter. [13921/21]

Gerald Nash (Louth, Labour)
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1317. To ask the Minister for Health the methodology, evidence, depth and expertise required in reports on deaths and Covid-19 outbreaks HIQA requires from nursing home providers; and if he will make a statement on the matter. [13922/21]

Gerald Nash (Louth, Labour)
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1318. To ask the Minister for Health if HIQA requires only the view and opinion of the providers and not that of independent experts in the reports on Covid-19 outbreaks and deaths in facilities requested from nursing home providers; if HIQA also seeks alternative independent opinions on the causes of outbreaks and deaths in nursing homes; if not, if it solely accepts the reports of the providers; and if he will make a statement on the matter. [13923/21]

Gerald Nash (Louth, Labour)
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1320. To ask the Minister for Health if it is the policy of HIQA that no inquiry, investigation or examination is needed into any deaths in any nursing home as a result of the Covid-19 pandemic; and if he will make a statement on the matter. [13925/21]

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 1316 to 1318, inclusive, and 1320 together.

The Chief Inspector of Social Services within HIQA has statutory responsibility for the registration and inspection of nursing homes and other residential services for children and adults with disabilities. As part of her legal remit, the Chief Inspector can inspect nursing homes and other residential settings and can make binding decisions relating to the safety and quality of care provided to residents following inspection. 

The Chief Inspector has a suite of statutory civil and criminal enforcement tools at her disposal where it is determined that the registered provider is not in compliance with their statutory duties and where the health or welfare of residents are at serious risk. These tools range from the issue of statutory demands for information to the cancellation of registration. Where a registered provider fails to discharge their statutory duties they are liable to prosecution before the courts. 

The person in charge of a nursing home has a legal obligation to submit monitoring notifications to the Office of the Chief Inspector of the occurrence of certain events in the centre, including any case or suspected cases of COVID-19 among residents or staff. 

The duties of the person in charge and the registered provider in relation to these monitoring notifications are set out in the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013, as amended, specifically in Regulation 31 and Schedule 4.

Monitoring notifications that must be submitted by the person in charge of a nursing home within three days of the event occurring and that are directly relevant to HIQA’s response to COVID-19 include:

- The unexpected death of any resident , including the death of any resident following transfer to hospital from the designated centre; and

- Any outbreak of any notifiable disease, including Covid-19. 

HIQA reviews these notifications daily as an indicator of the extent of COVID-19 outbreaks in individual nursing homes and across the sector.  An established communication pathway ensures that information pertaining to an outbreak is shared in a timely fashion between the HSE crisis management teams and the Office of the Chief Inspector.  

I am advised by HIQA that Inspectors have carried out inspections in many nursing homes either during or following an outbreak. To date the Chief Inspector has not requested the input of an independent expert as it considers Public Health to be the definitive authority in managing this Public Health Emergency.  

HIQA has submitted a document to my colleague, Minister for Health, Stephen Donnelly, which recommends a review of the current legislative and regulatory framework. A bilateral group has been established between officials in my Department and representatives from the Office of the Chief Inspector, for engagement on this matter.  

HIQA encourages every provider who has experienced an outbreak of COVID-19 in their centre to complete a post outbreak review and to ensure that any learning from an outbreak is actioned.  In addition, each registered provider is required to complete an annual review of the quality and safety of care delivered to residents in the designated centre to ensure that such care is in accordance with relevant standards set by the Authority.

Gerald Nash (Louth, Labour)
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1319. To ask the Minister for Health his views on whether in-house reports on Covid-19 outbreaks and deaths created solely by the nursing home management are adequate to report on, address concerns and ensure learning about outbreaks of Covid-19 and the deaths and infection of residents; and if he will make a statement on the matter. [13924/21]

Mary Butler (Waterford, Fianna Fail)
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Nursing home providers are ultimately responsible for the safe care of their residents. Reports of this nature are completed by registered providers. I am advised by HIQA that its inspections are focused on reviewing the systems in place to ensure safe care for residents. To this end the Chief Inspector published “COVID-19 – an assurance framework for providers” last September to ensure that providers are continuously reviewing their service and making changes as new information / guidance becomes available or following an outbreak.  Inspectors may ask to review the associated providers self-assessment and quality improvement document.   

Where inspectors are concerned that the provider may not have addressed issues which were identified during an outbreak these will be reviewed – if the solution is allowed for in the current legal and regulatory framework then compliance is required.  Where inspectors are not assured that the provider has the expertise to address issues of concern (particularly in the area of infection prevention and control) then a request can be made to the HSE crisis response team to support the provider in addressing these issues. 

The Nursing Homes Expert Panel was established, on foot of a NPHET recommendation, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort. This Expert Panel report has added further to our knowledge and learning. This report clearly outlines the key protective measures that we must ensure are in place across our nursing homes. These actions are based on learning from our own and the international experience of COVID-19 to date. 

The report also recommends additional analysis and examination of the relevant public health and other data sets in order that further causal and protective factors for COVID-19 clusters are identified. 

Work to progress the recommendations of the Expert Panel report, particularly those recommendations requiring a priority focus in the response to COVID-19, is ongoing across all of the health agencies and stakeholders. Continued learning and understanding of progression of the disease in Ireland is an integral part of those recommendations.

Gerald Nash (Louth, Labour)
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1321. To ask the Minister for Health if the CEO and chief inspector of HIQA have met with the families of any of those who died in nursing homes during the Covid-19 pandemic; if they are willing to do so; if not, the reason this is the case; and if he will make a statement on the matter. [13926/21]

Mary Butler (Waterford, Fianna Fail)
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I am advised that HIQA, as an organisation, has been communicating on an ongoing basis with the families of deceased residents and from the outset have endeavoured to ensure all families have equitable access to relevant information and advice. 

HIQA’s concerns team has had multiple contacts with family members and the team has endeavoured to take account of their experiences, answer their queries in relation to HIQA’s regulatory role, and signpost families appropriately to have their questions answered by the relevant agency. HIQA is satisfied that the systems that have been put in place are effective and will remain in place. 

My Department liaised with the Chief Inspector in relation to facilitating access to advocacy services for residents of Dealgan House Nursing Home and their families and this service was subsequently made available by the Patient Advocacy Service.