A report by a UK consultancy into the closure of Leas Cross nursing home in Swords, Co Dublin, last year - commissioned by the home's owner John Aherne - has criticised the Health Service Executive (HSE) for "dumping" pre-terminal and terminal patients in the nursing home. It says this was done to free up acute beds in the surrounding area.
Separately, The Irish Times also understands that legal advice provided to the HSE earlier this week says that if it publishes another report into Leas Cross, which the HSE commissioned consultant geriatrician Prof Des O'Neill to conduct on its behalf, this could lead to the prospect of a successful judicial review restraining publication and possible claims for damages.
Instead, it is believed that the HSE has been advised that each of the individuals mentioned in the report should be given the opportunity to make an oral and written presentation to Prof O'Neill, with an entitlement to call appropriate evidence to justify their own position or conduct. But if Prof O'Neill did not wish to do this, the entire review would have to start again.
Prof O'Neill has previously described his report's findings as "grave" and "disturbing".
Yesterday, The Irish Times also reported that his investigation had found that none of the deaths at Leas Cross was preventable.
The review by the UK-based Elderly Care Consultancy Services (ECCS), conducted by Dr Jonathan Levy and elderly-care consultant Rita Craig on Mr Aherne's behalf last year in advance of a possible sale of the home, also finds that there was no evidence of "contributory neglect" by the home in 30 random cases.
These were a review by Dr Levy of patients aged 65 to 96 years who died either in Leas Cross or after referral to local hospitals.
"Of the cases investigated, all had serious medical conditions that were either pre-terminal or terminal," Dr Levy states in the report. "These patients were in fact admitted into beds that were contracted to the health board and in all honesty it looks like these pre-terminal and terminal patients were 'dumped' on to Leas Cross in order to free up acute beds in the hospitals."
While this was a "normal procedure", he suggests that Leas Cross should have been informed of the more severe medical state of the patients "so that they could have a chance to assess them and to decide where they could best place them".
The ECCS report, which the HSE yesterday said it had not seen, also claims that it used the nursing home "like an extension of St Ita's hospitals and Beaumont Hospital" due to the level of admissions for respite care, 64 admissions between November 2004 and June 2005.
"It would be extremely difficult for any nursing home to cope with this amount of admissions during the most severe months of the year," Ms Craig says.
Yesterday, she said she had spent approximately three months examining the nursing home, interviewing patients and staff members and examining files, both before and after it closed in August of last year. She had been unable to interview HSE staff, despite attempts to do so, she said.
Dr Levy completed his section of the report last October.
Ms Craig goes on to criticise the failure of the HSE to make adequate recommendations to the management of Leas Cross, for example the appointment of a mental health care needs manager and registered mental health nurses.
A spokesman for the HSE declined to comment on the findings, but said he would be "very curious" as to the methodology used in the report.
"The HSE has not received that report, and therefore is not in a position to comment on it.
"Quite clearly, whatever any report says, there were problems at Leas Cross, and we could not allow the home to continue looking after clients."