Nursing homes controversy: What we know so far
Tomas Doherty
A documentary broadcast on RTÉ this week revealed serious issues at a number of nursing homes.
The film examined standards of care at nursing homes operated by Emeis Ireland, formerly known as Orpea. The French-owned company runs 27 residential homes across the State.
Undercover researchers found multiple examples of care failings and neglect of vulnerable older residents in the facilities.
Here is everything we know so far about the controversy, including the growing political reaction.
The background
The RTÉ investigation found concerning issues at The Residence Portlaoise and Beneavin Manor nursing homes.
The documentary highlighted vulnerable people being left unsupervised, large amounts of residents congregated together being supervised by one member of staff, and requests for the use of toilets being unanswered for lengthy periods of time.
It also showed some staff not using proper hoisting equipment and shortages in necessary items like incontinence pads.
RTÉ had two undercover researchers simultaneously apply for and secure healthcare assistant roles at the Emeis homes. They both had all the required qualifications and were Garda vetted by RTÉ.
At The Residence Portlaoise, up to 101 residents can be accommodated at a weekly cost of approximately €1,200 per week under the Fair Deal scheme. The Fair Deal scheme is a State support system that helps cover the cost of nursing home care, based on a person’s income and assets.
The undercover researchers did witness some staff provide good care but more often saw repeated instances of staff shortages impacting daily resident care.
This included large groups of residents being congregated together in day rooms, vulnerable older people being left unsupervised resulting in resident falls and day-to-day requests going unattended to for lengthy periods of time such as pleas to be put to bed or use the toilet.
The undercover carer also witnessed multiple examples of poor manual handling with older residents frequently lifted under the arms and without the required use of proper handling equipment contrary to best practice.
On some occasions staff were hampered by a lack of available equipment, while in one instance management also instructed healthcare assistants not to use hoisting equipment in public areas for fear their poor technique would be seen by visitors.
At Beneavin Manor in Dublin, which can provide care for up to 115 adults for approximately €1,400 per week with Fair Deal funding, another undercover researcher saw similar patterns of staff under pressure. Staff also faced constant challenges when it came to the supply of essential resources with recurring shortages of basic items such as towels, bedsheets, sanitary wipes and gloves.
The researcher also witnessed the inappropriate handling of vulnerable residents with frail older people sometimes moved by their clothing instead of using the correct handling equipment mandated in their care plans.
RTÉ had both researchers hand in their notice and report all their concerns to management at the nursing homes and to the regulatory body, the Health Information and Quality Authority (Hiqa).
The response
In response to the documentary, Emeis Ireland issued an apology to to all residents and their families for “the suffering and distress experienced as a result of failures identified in the care provided”.
It said it recognised and deeply regrets the “breach of trust” and “any failure to uphold the dignity of some residents at all times”.
Emeis Ireland said it has commenced a comprehensive review across both nursing homes.
Hiqa, which is responsible for inspecting nursing homes, said it is taking “escalating action” over the “wholly unacceptable” practices identified in the programme.
It said a decision to halt admissions to the Residence Portlaoise came into effect in April.
Minister for Enterprise Peter Burke expressed his distress at the revelations in the RTÉ investigation.
“It was very distressing to see vulnerable people to be treated the way they were. When you consider elderly people who have given so much for our economy, for our state, to be treated like that in their twilight years was absolutely reprehensible,” he told RTÉ’s Today with Claire Byrne show.
Labour TD Alan Kelly said Hiqa had a “lot of questions to answer” following the broadcast, adding that the agency needed to be properly supported to “actually do its job”.
Mr Kelly said demographic changes in the country necessitate a completely different strategy for care of older and vulnerable people, including more public nursing homes and plans for increased home help and care in the home.
He also said Hiqa and other organisations need the Government to put an adult safeguarding framework in place.
The chairwoman of Safeguarding Ireland said she was “disturbed, distressed, and angry” over the findings of the programme.
In reference to a previous RTÉ documentary on the Leas Cross Nursing Home 20 years ago, Patricia Rickard-Clark added: “We have gone backwards, I think.”
Ms Rickard-Clark told RTÉ’s Morning Ireland that the Government needs to establish an inter-department and inter-agency working group to deal with recommendations from the Law Reform Commission on adult safeguarding.
Disability Minister Norma Foley described the programme as “horrifying” and “heartbreaking”.
“To see older people struggle to be heard, to be listened to and to be cared for is quite appalling.”
Ms Foley said she believed that a lack of guidelines on staff-to-resident ratio in nursing homes should be “looked at”.
What next?
A review of all nursing homes operated by Emeis Ireland has now been requested by the Department of Health.
Minister of State at the Department of Health with responsibility for Older People Kieran O’Donnell has asked Hiqa to start the review of all nursing homes operated by the group in the wake of the RTÉ Investigates programme.
He said the treatment of residents at the nursing homes was “extremely distressing” and “wholly unacceptable”.
The Minister said he wanted to see inspections happening more frequently and faster responses to protected disclosures.
Hiqa’s chief inspector “is taking escalated regulatory action in the nursing homes identified” and “will take any necessary additional actions with the provider to ensure safe and effective care and support to all residents”, a spokesperson said.
Hiqa ordered admissions to The Residence in Portlaoise to be ceased after the release of a report in February detailed areas of significant concern. – Additional reporting: Vivienne Clarke, Press Association
