Residential care home staff who were close contacts told to keep working

Healthcare staff deemed to be close contacts of Covid-19 cases have continued working in some residential care facilities rather than restricting their movements while waiting for test results, the State healthcare regulator has said.

Staff in two residential centres for people with disabilities received exemptions to continue working in late December, despite being close contacts of cases, until their test results came back.

Eight staff from one centre identified as close contacts of a case were advised to keep working after a derogation was received from public health officials.

In correspondence with the HSE, the Health Information and Quality Authority (Hiqa) said the facility had "no confirmed date available for testing of staff".

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Normally healthcare workers identified as close contacts must restrict their movements for 10 days, and only return to work following a negative Covid-19 test.

In another residential disability centre 10 staff were identified as possible close contacts but also received an exemption to continue working.

It was “not clear” when several of these workers would be tested, Hiqa told the HSE in a December 29th email.

Since November there has been 193 outbreaks of Covid-19 in nursing homes, community hospitals and long-stay residential units, accounting for 4,096 cases and 262 deaths.

Nursing home residents have accounted for around half of the more than 3,000 fatalities from Covid-19 during the pandemic. The vulnerable cohort has been prioritised for vaccination, with the vast majority of those in the facilities receiving a first dose in January.

Daily updates

Correspondence also shows the regulator escalated concerns about several serious outbreaks in nursing homes to the HSE over the course of Christmas week. The daily updates highlight worsening conditions in several nursing homes as the third wave began to hit the sector.

The correspondence was obtained by The Irish Times under Freedom of Information laws, although the names of the nursing homes were redacted.

Thirty of the 42 residents in one home had tested positive for Covid-19, along with 17 staff. The facility had an “urgent requirement” for oxygen equipment, Hiqa told the HSE on December 21st.

"The majority of staff who are Covid positive are nurses and the centre is struggling to secure nurses …The provider has reported that agency staff coming into the centre will only care for negative residents," Hiqa's director of regulation Mary Dunnion said.

Two days later the nursing home only had one member of cleaning staff available despite pleas for additional workers.

In another facility 41 people had tested positive with the outbreak “now affecting nearly all residents in the centre”, Hiqa warned.

In a nursing home with 15 confirmed cases, Ms Dunnion said “one staff member is refusing to be tested”. The facility was deemed high-risk as it had “very poor physical premises” ,with the outbreak traced to a large bedroom accommodating 11 residents.

Management in the nursing home were concerned “that if more nurses test positive they will not have enough staff,” Ms Dunnion said.

Confirmed cases

In a December 23rd email to the HSE, Hiqa said another nursing home had 23 residents and 28 staff who were confirmed cases.

“They had only two staff nurses last night as an agency nurse did not turn up at 8pm,” Hiqa said. “They have requested staff nurses from the Covid support or HSE but have been told they have none to give them. The agencies also say they do not have staff nurses.”

A day later Hiqa told the HSE the number of residents with the disease in the nursing home had increased to 27, and four were in hospital. The nursing home had advised it had “no nurses available for tonight,”, and an “inexperienced nurse” was left in charge of the facility that day, it said.