See what the under fire nursing home  charges for additional services

A PUBLIC representative provided details of extra charges residents who are being cared for in The Residence private nursing home in Portlaoise are charged should they request additional services or aids.

Cllr Caroline Dwane Stanley produced a copy of the detailed contract at this morning’s municipal district council meeting in Portlaoise.

The contract between The Residence and residents sets out that, on top of the weekly set fee of €1,200 should patients require physiotherapy they will be charged €60 per session. Hairdressing is charged at €18 for a shampoo and set; Shampoo cut and set €36; Perm €65 and a gentleman’s cut €12. Should residents require labelling on their clothes it will cost them €20 for 120 labels. Escort with a healthcare assistant to and from an appointment will be charged at €20 per hour. Escort with a registered nurse - €45 per hour while incontinence wear (no-medical card holders only) is charged between €40 to 90 per month.

The contracts also sets out that should residents require a wheelchair repaired it will cost them €95, plus parts. The annual maintenance on pressure relieving mattresses will cost €65. Repair of a pressure relieving mattress is charged at a rate of €25 per 15 minutes, plus parts.

Regarding fall monitoring equipment, The Residence charges its residents the rental of bed/chair sensor mats at a rate of €15 per week. For their repair there is a charge of €25 per 15 minutes, plus parts. Should residents require crash mats they will be charged between €120 to €200 per mat.

The charges stunned Portlaoise councillors at their meeting, who have now demanded that officials from the Health Information and Quality Authority (HIQA) and the Health Service Executive (HSE) meet with them, “face to face” to answers questions on the shocking finding in the recent RTÉ Investigative report on two privately owned nursing homes, one in Portlaoise, The Residence.

Cllr Dwane Stanley received the full backing from her fellow councillors in her motion for an immediate meeting with HIQA and the HSE “to address the huge concerns around the appalling treatment of residents in the running of nursing homes in Portlaoise.” 

She said: “It’s amazing to think that over €1billion of taxpayers money is going to private nursing homes every year. We have farmed out nursing homes to private entities. Over the past 20-years 81% of our nursing homes are now being run as profit making businesses. Profit, being their priority and not the resident who should be front and centre. Their well-being and safety should be the priority. In a new report we now see that almost 200 complaints of abuse had been made between the nursing home in Dublin and The Residence in Portlaoise. It took HIQA over two years following disclosure by a whistle-blower to do the work that it should have been doing.” 

Cllr Dwane Stanley said that she has been dealing with a number of families.

“One is currently in The Residence over a year,” she said: “This individual had pneumonia three times in the space of 12-months. The last report that the family received from Portlaoise hospital, when their loved one went in, he was diagnosed with malnutrition. How do you get malnutrition when you’re supposed to be looked after in a nursing home in unbelievable.

“His family has given up completely on addressing the management in The Residence. They have been told on numerous occasions, that their concerns would be addressed, such as dirty bedding and his unkempt appearance.

“This resident has no children. So on top of the weekly fee of €1,200, it’s his brothers, sisters, nieces and nephews who are polling money together on a weekly basis to pay for the added extras. Almost the full amount of the man’s €240 weekly pension goes to the nursing home. He’s charged €63 a month for his vitamin medication. Health insurance €35 a month. If he has to get a private wheelchair capable taxi over to Tullamore hospital, where he has an appointment, it’s €140, that his family has to pay for. If a staff member has to travel with him, he’s charged €20 an hour. I’m sure we’re all aware of how long it takes to be seen for an appoint when you go into a hospital. You could be waiting hours.” 

Cllr Dwane Stanley continued: “When you go inside one of those rooms in the nursing home, you have to practically rent everything. To rent a foam mattresses will cost €25 a week. The air mattresses that prevent bedsores, you can buy off the nursing home for €800 or provide your own. A television package costs you €40 a week. There’s a charge for a nurse to take blood samples and a charge is you request a chiropodist. If the person has a skin allergy their loved ones have to buy the medication for that as well.”

“It was frightening to see in the most recent report, that HIQA advised the (two) nursing homes not to take in any more residents. Yet they ignored that advice. I can’t understand why HIQA did not compel them to do it. I have no confidence in HIQA. It has let people down. The nursing homes have let their residents and families down. These are people that we all know. We know who these loved ones are. To think that they have been treated so despicably, almost treated like they were in the way, a hindrance. It’s disgraceful.” 

She said: “I want my opportunity to ask HIQA why they allowed this to go on for over two-years. They need to be held accountable for what they’ve done. I also want to say, that the state run nursing homes (Mountmellick, Shaen and Abbeyleix) in this county are second to none. We should be expanding these and not farming out our elderly people. I hope HIQA and the HSE have the guts to come in and us, the public representatives. The spotlight is on these facilities now, but what’ll happen when the spotlight goes off them?” 

Cllr Catherine Fitzgerald described the RTÉ programme “as absolutely so distressing and harrowing to see this happening in our own town to our own people.” 

She informed the meeting that Deputies Willie Aird and Sean Fleming have arranged to hold an on-line meeting along with local councillors and representatives from HIQA.

She said: “We look forward to a date for that meeting. But, I’d prefer to meet them in person. What I want to know is, if HIQA advised the homes to stop taking in residents, who paid for the care of the people that they took in after that? If they were advised by HIQA no more admission, who was paying the Fair Deal? It seems to me that one hand (HSE) didn’t know what the other was doing and that they (HSE) didn’t want to know. 

"The HSE didn’t want to know that there were major problems and kept going regardless. It would have been a problem for the HSE to have to sort out proper good accommodation for the residents. It’s absolutely horrifying and people are terrified. People who are considering getting their loved ones into nursing homes don’t know what to do. Are these facilities not able to mind them? We depend on these nursing homes. But they are letting us down. It has put the fear of God in so many people and families in the area.” 

Cllr Marie Tuohy said: “These people are our friends and neighbours. I think it’s about time that people who provide care for their own families in their own homes are treated with respect and dignity and paid appropriately. Image the money that could be saved? 

"It was break-breaking and you couldn’t of been so disgusted by what you seen on Primetime Investigates. We need to see action provided for home carers with supports and treated them with respect as they should be treated.” 

Cllr Tommy Mulligan said that he recalled in 2005 looking at the scandal unfold on the Leas Cross Nursing Home that involved substandard living conditions and inadequate care for elderly residents.

He said: “The whole country was outraged. It’s shameful, 20-years on this is still happening in our country. We only got a snap-shop over the past 18-months. God knows of what else was going on. I believe HIQA are culpable. Management are culpable too. Who was setting and overseeing the standards? The care workers are getting a lot of criticism.

“The new report says that HIQA had received 40 allegations of abuse in 18 months. 17 notifications of serious injuries and incidents. 23 unexpected deaths. It received 11 unsolicited pieces of information from residents. Obviously people were aware of what was going on. Three were protected closures from an employee or a health professional and five from relatives.” 

Cllr John Joe Fennelly said: “It was a heart-wrenching (RTÉ) programme. I went to bed and couldn’t sleep after watching it. To thinks 12-years ago they tried to close Abbeyleix hospital. We had 52 patients in Abbeyleix hospital then, and now it’s down to 22. There’s no-term care there now. But. at least we have a hospital and staff in there.

“It’s about time we started looking after people who provide care in their own homes. This is the best type of care that people can get. You’d have to wonder how management could stand over what we saw happen on the programme?”

 “I was completely shocked, watching the programme,” said cllr Barry Walsh. “It was scandalous. To think that people who worked hard all their lives, contributing to society and end up in that situation is totally unacceptable.

“I’m sure when HIQA, or whoever comes in in front of us, and the first thing that they will say to us is that that are under-staffed. But that is not acceptable. People are paying good money for a service through the Fair Deal Scheme, it’s anything but a fair deal scheme for a lot of people.” 

Cllr Dwane Stanley said that while an online meeting is being arranged by the two Dáil deputies with public representatives she said: “A letter should go requesting them (HIQA and the HSE) to meet with us in person. I want to be able to look them in the eye and asking them questions.” 

Cathaoirleach of the municipal district council cllr Paddy Buggy said: “I want to be associated with this motion and I support it fully. It was horrifying to watch. It reminds you of the great care provided in Shaen, Abbeyleix and Mountmellick. There’s great work being done on expanding Mountmellick and I’d like to see Shaen and Abbeyleix expanded too and long-term care put into the facilities. The care they provide is second to none.” “There are some good people working in private nursing homes, but unfortunately they are all being targeted with the one brush. That’s not fair on them. It’s management that is not being given the resources or support that they need to be able to look after their clients to the highest standards. Some people working in those private nursing homes are nearly ashamed to say that they are working in them, because of the bad press, which is deserved,” he said.

Summing up cllr Dwane Stanley said that before the recent scandal broke, she received a number of complaints from families of residents in nursing care and said: “I know that HIQA are now starting to look at Kilminchy Lodge (owned by Emeis Ireland, the same owners of The Residence).

“But not everybody conducts their work in a bad way. Look at Ballard Lodge for example. HIQA came with a report, which had nothing to do with the care being provided, which was absolutely second to none. But unfortunately small nursing homes like that are being squeezed out of the market for the bigger places where all they are interested in is money. They don’t care about the residents. It’s all about the money to them.” 

Waving a copy of The Residence list of extra additional charges, cllr Dwane Stanley said: “This is the proof of it. It’s a shocking list that they hand to the families when they put their loved one in to their care. It has a price for everything that they want to use.”