Serious concerns regarding administration of drugs, understaffing and poor hygiene at Rostrevor Nursing Home, Dublin, were expressed by health board officials at various stages over the last four years.
In affidavits read out before the High Court, inspection officials said standards of care for the home's 23 patients had not changed substantially despite repeated warnings.
South Western Area Health Board officials said one of the most serious findings was the administration of discontinued drugs to some patients, and the inappropriate storing of other controlled medicines.
The breaches were mostly under the Nursing Homes Act (1990) and the Nursing Home Care and Welfare Regulations (1993), which provide for the twice-yearly inspection of private nursing homes.
One health board inspector recorded several "serious breaches", including drugs being given to patients which were either undated or out of date, while the home had failed to keep a proper record of drugs and medicines administered. Despite a mandatory daily check, it was found that powerful drugs, such as morphine, were not properly accounted for.
In at least one case a drug was administered to a patient despite a GP specifically asking that it be discontinued, the court heard. In another case drugs were prescribed for a patient who no longer lived in the home.
Drugs were sometimes stored in inappropriate locations, the official said, and on two occasions an unlocked trolley with drugs was found unsupervised, accessible to patients and staff.
On another visit inspectors expressed concern over some patients' bedsores. During subsequent visits it was found that insufficient steps had been taken to deal with the condition.
In one case the dressing of an incontinent patient's bedsore was improperly prepared and contaminated by faecal matter. Furthermore, it was discovered that the date of death of one patient was not recorded by the nursing home.
There was also concern about staffing levels. During a visit in 2002 there was no nurse on duty, in contravention of regulations.
Inspection teams also found that on at least three occasions the front door of the home was unlocked and left open, despite numerous instances where residents had wandered out of the home. Fire safety precautions were also insufficient and during the last fire drill, just seven of the 16 staff took part, an official said.
The owner of the nursing home, Ms Teresa Lipsett, who has worked in the sector for more than 20 years, contests many of the allegations, saying they were "historical". In an affidavit she said staff were administering drugs in accordance with doctors' instructions. While there had been serious difficulties recruiting and retaining staff in recent years, a new matron had recently been appointed.
Ms Lipsett said she had not received complaints from patients and was not aware of anyone wishing to move to a new nursing home, following a discussion with patients and relatives.
A decision by the High Court on whether it will issue an injunction to close the home is expected tomorrow.
The board, which received 70 calls to a helpline it set up earlier this week, says it has identified alternative accommodation for residents, available immediately if the injunction is granted.
