ANALYSIS:ON AUGUST 31st last year, Dublin's St James's Hospital signed a contract with a private nursing home in Maynooth, Co Kildare.
The deal, brokered in a bid to free up beds in the hospital, would mean 50 patients discharged to the TLC nursing home over a three-month period.
However, the terms of the contract were not adhered to and 40 patients were admitted to the nursing home in a 30-day period.
An independent inspection of the home in October by the Health Information and Quality Authority (Hiqa) found the home essentially wasn’t adequately prepared for so many admissions at once. It had more than doubled in size and “inspectors did not find clear evidence that the provider had employed sufficient staff members to ensure that the admission process was adequately carried out for the significant number of residents who moved to the centre in a short space of time”.
The centre claimed extra staff were taken on to help but there was no record of these additional staff on the rota.
The inspection report, published yesterday, concluded that the purpose-built home, with a hair salon and cinema, did not show good judgment in admitting so many new residents so quickly.
It makes no comment though on the judgment of the largest hospital in the State in discharging so many patients so quickly to a home which could not cope.
How do we know this? Well, staff at the centre who were spoken to by inspectors said they were too busy the previous day to change a dressing on a patient which had an offensive odour coming from it when inspectors arrived, and some relatives of those in the home said they had to wait “a long time” for call bells to be answered. They also claimed patients were put to bed early, as there were not enough staff available in the evening.
What is striking about the findings of this inspection report is that they mirror to some extent what happened when a large number of patients were transferred from St Ita’s Hospital in Portrane, Dublin, to the controversial Leas Cross nursing home in 2003. The influx of patients from St Ita’s – whose transfer was organised by the former Northern Area Health Board, which contracted beds from Leas Cross – over a short period coincided with a significant deterioration in standards of care in Leas Cross, a commission of investigation subsequently found.
While deficiencies at the Maynooth home were nothing compared to those found at Leas Cross, the Leas Cross report provided a warning to hospitals and health service managers to take care in discharging large numbers of patients to nursing homes over a short period.
The findings of the commission of investigation into Leas Cross were published in July 2009 – two weeks before St James’s signed the deal with the Maynooth home. Yet its findings were not taken on board.
A spokesman for St James’s Hospital said the hospital was taking the view that if the TLC Centre was registered and accepting its patients, it was prepared for them. It was acting in good faith.
“It’s a very important issue that has been highlighted and one that has to be taken on board for the future,” he said.
But in reality, St James’s should have done more. It should have made sure the home was prepared for its patients, if the lessons from Leas Cross had been learned.
St James’s said it will be studying Hiqa’s inspection report carefully, and any issues that need to be addressed will be covered during discussions with the nursing home.