CONCERNS ABOUT standards at a Co Meath nursing home were expressed yesterday during court proceedings to have it removed from the State-approved register, which would result in its closure.
Drogheda District Court was told residents experienced 19 falls over a six-week period at Creevelea House Nursing Home in Laytown.
The court was also told that heating at the home was not working properly, increasing risk of hypothermia for some residents, and that the home had been broken into three times.
The court also heard the home “was not clean” and, on inspection, the only fresh food in the kitchen was one bag of potatoes and a turnip. There was no meat.
The evidence was given by an inspector with the Health Information and Quality Authority during an application relating to Creevelea House Ltd, the registered operator of the home.
The authority is asking the court to cancel its registration as a nursing home, a decision that would close it down.
The application is opposed by Peter Murphy, director of the company and the registered provider of the home.
The authority says it has “serious concerns” about the health and welfare of residents at the home. These relate to lack of governance, clinical management, and lack of staff training.
An authority inspector Nuala Rafferty told Judge Flann Brennan the first of a number of inspections took place in March last year after the niece of a resident got in touch over concerns about his care.
Ms Rafferty said that when inspectors arrived they found “nobody running” the home, and “nobody overseeing the management of residents”.
Mr Murphy lived in Limerick, she said, and there was no emergency plan in place to guide staff on what to do in cases of difficulty.
The person staff contacted if there was a problem was a staff nurse who worked 24 hours a week, the court heard. She was to be contacted even when not working.
In reply to questions from Ronan Kennedy, for the authority, Ms Rafferty said inspectors met Mr Murphy and issued him with an emergency action plan.
She said he did not seem aware of the level of concerns they had, and felt that the inspectors were creating problems for him and he felt bullied and intimidated.
He also indicated he would prefer to talk to a senior management person in the authority.
The court heard of concerns about a 93-year-old woman who potentially had not eaten for 24 hours. There was no nutritional plan for her and she had not been weighed.
Another resident, aged 66, was not having his diabetes condition monitored properly and, although he had a history of falls, he was not adequately supervised, the court was told.
Inspectors had specific concerns about seven residents at the time of the first inspection, Ms Rafferty said.
The court heard there had been 19 falls over a six-week period. In one case a woman fractured her hip.
A person was appointed last year to take charge of the home but she resigned in December because she felt she was not getting the support she needed, the court heard.
Ms Rafferty said that on November 20th last, at the start of the bad cold spell, “staff complained of being cold” as she carried out a follow-up inspection.
The inspectors found only four bedrooms to be warm, the rest “very cold”, and all the communal rooms were also “very cold”.
They returned the following morning and found all were 2 to 3 degrees below what they should have been.
Seven residents had temperatures below 36 degrees and were “now verging at risk of hypothermia”, the court heard. The heating was not left on for long enough to reach an optimum level and remain there, it was claimed.
The inspectors directed staff to give out warm drinks and extra blankets.
Judge Brennan also heard that two of the four fuse boards did not meet electrical safety standards.
There had been three break-ins, one during which a resident heard somebody in a bathroom a short distance from her bedroom.
She believed it was another resident who had got locked in and she began to call out to him.
When staff arrived they found the window inside the bathroom had been broken and somebody had broken in.
The next morning a hacksaw was found outside and a shed in the grounds had been broken into.
There was no CCTV at the time but it was in place now and there were alarms on the windows, Ms Rafferty said.
There was no evacuation plan in place if a fire broke out, and while one was now in place, the court heard that staff did not know about it.
There were concerns about an alleged gas leak in the kitchen, and the chef had at one point gone home with violent headaches and vomiting.
In March this year the authority found there was still a lack of clinical governance and a lack of adequate care, and residents were at risk.
It contacted the HSE, which carried out an assessment of the residents and since then had had staff in the home.
In April, in court, Mr Murphy undertook to meet a number of commitments required by the authority but yesterday the authority said that while there had been some improvements, it still believed there was a “serious risk” to the remaining nine residents.
Staff numbers had dropped at the home and Ms Rafferty said yesterday: “It is not about numbers, it is about the needs of the residents.
“Our concerns are about the needs of older people and how they will deliver [on] them.”
Reports of two recent visits by the authority were given to the legal representative for the nursing home in court yesterday.
The hearing is to continue in two weeks.
Mr Murphy is expected to give evidence on the next date.