Fergus O'Dowd (Louth, Fine Gael)
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820. To ask the Minister for Health the powers the public authorities had in dealing with private nursing homes which were failing to comply with public health guidelines during phase 1 of the pandemic; and if he will make a statement on the matter. [24774/23]

Mary Butler (Waterford, Fianna Fail)
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The COVID-19 pandemic has presented one of the greatest and most wide-ranging public health challenges internationally in recent history. The pandemic was a hugely difficult time in particular for all residents, relatives and staff of nursing homes.

The State’s responsibility to respond to the public health emergency led to the establishment of a structured nursing home support system, in line with National Public Health Emergency Team (NPHET) recommendations, to provide enhanced supports to public and private nursing homes. In order to support continuity of service and infection prevention management, a comprehensive package of direct and indirect supports was established in early 2020 and remained in place throughout.

Supports

The supports provided over the course of the pandemic have included:

• Enhanced HSE engagement;
• Temporary HSE governance arrangements for some private and voluntary homes;
• Multidisciplinary clinical supports at Community Healthcare Organisation (CHO) level through 23 COVID-19 Response Teams.
• Substantial support and advice through the Departments of Public Health and Outbreak Control Teams;
• The HSE through the COVID-19 Contact Management Programme and the Public Health Departments prioritised the investigation and management of outbreaks in nursing homes;
• Access to supply lines for personal protective equipment (PPE), medical oxygen etc. including access, free of charge, to PPE on both a precautionary and an outbreak basis;
• HSE training and development resources, including the opening up of the HSE’s online training portal and learning resources (HSELanD) to private and voluntary providers.
• Infection Prevention and Control (IPC) support and advice, including a package of IPC guidance produced and published in March 2020, in addition to the pre-existing HSE and HIQA guidance.
• Access to staff from HSE community and acute hospitals: from an early stage the HSE mobilised considerable staff resources, making them available to nursing homes where possible.
• A substantial suite of guidance (visiting, IPC) was developed to support the nursing home sector and updated regularly as new evidence emerged and the epidemiological profile changes was developed.
• The HSE ran a programme of serial testing of all staff in nursing homes. The programme commenced on 24th June 2020 and operated in full until approximately April 2021, after which nursing homes were permitted to exit the programme if they met nationally agreed exclusion criteria.
• Free temporary accommodation to nursing home staff to support measures to block the chain of transmission. This scheme ran up until May 2022.
• As part of package of support measures for nursing homes, the Minister established a COVID-19 Temporary Assistance Payment Scheme (“TAPS”) for private and voluntary nursing homes, providing for a publicly funded contribution to their preparedness, resilience and the management of COVID-19 outbreaks. The Scheme opened for applications on 17th April 2020 and delivered in excess of €149m in funding to the private and voluntary nursing home sector over the course of the pandemic. This payment was extended to the end of April 2023 and subsequently closed as the frequency and severity of outbreaks has greatly reduced.

• A quality assurance process was set up, whereby all nursing homes were phoned on a fortnightly basis by an inspector of social services. These calls were to assess the welfare of the residents, how nursing homes were coping, any concerns they had and any deficiencies identified in their ability to sustain a safe, high-quality service.
• New registration applications were prioritised to facilitate the swift opening of new residential placements.
• An ‘Infection Prevention and Control Hub’ support service was set up by the Chief Inspector. The Hub, staffed by inspectors with experience in infection prevention and control, acted as a source of immediate advice and support for centres that had queries on COVID-19 outbreak prevention and management.
• Eight regulatory information notices were issued to registered providers between 20 March and 26 June 2020. These were aimed at enhancing the flow of notifications that providers are required to make to the Chief Inspector. This enabled the timely return of data on the number of residents and staff with suspected or confirmed cases of COVID-19, and the number of deaths in each centre.
• There was regular liaison between the Chief Inspector and the Department of Health and the HSE regarding ongoing issues in services and the escalation of risk.
• The Chief Inspector carried out a programme of inspections to assess the preparedness and contingency planning for COVID-19 outbreaks in those nursing homes that had not yet had a suspected or confirmed case of the disease.
• The Chief Inspector also carried out a separate targeted programme of risk-based inspections focusing on those nursing homes that were most impacted by COVID-19.

Fergus O'Dowd (Louth, Fine Gael)
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821. To ask the Minister for Health if any warning letters were issued by the HSE or HIQA outlining concern on failures to comply with regulations issued to nursing homes in April 2020; if so, how many; and if he will make a statement on the matter. [24775/23]

Mary Butler (Waterford, Fianna Fail)
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The Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of Public Community Nursing Units and Private Nursing Homes. All these homes are subject to registration and inspection by HIQA, which is underpinned by a comprehensive quality framework comprising Registration Regulations, Care and Welfare Regulations and National Quality Standards.

In 2022 HIQA published an overview report on the monitoring and regulation of older persons services in 2020 and 2021. This report is available www.hiqa.ie. This provides an overview of the findings of the regulation of designated centres for older people throughout 2020 and 2021 by the Chief Inspector of Social Services.

HIQA has advised my Department that between 1 April 2020 and 30 April 2020, HIQA did not issue any warning letters to nursing homes. At that time, the country, including nursing homes, were in the very early stages of managing the impact of COVID-19. The regulatory focus during that unprecedented time was in relation to the management on COVID-19.