HSE inspectors found a series of failures in the nursing home in Bray, Co Wicklow, from which patient Maura Reynolds disappeared last Christmas, according to inspection reports obtained by The Irish Times. Alison Healy reports.
Mrs Reynolds (78), who had Alzheimer's disease and cancer, left the Tara Nursing Home in Bray, Co Wicklow, on the night of Christmas Day but her body has never been found. It is thought she may have fallen into the sea.
The Irish Times has seen two HSE inspection reports relating to nine complaints made by Mrs Reynolds's family about her care. All complaints were upheld.
However, the home owners, Paul and Anne Costello, have rejected many of the findings and described them as "unfair and unwarranted". Mr Costello, who is chairman of the Irish Nursing Homes Organisation, said the home's staffing ratio was above the national average and said Mrs Reynolds' care plan was carefully developed to meet her needs.
He said they had sought a meeting with the HSE to discuss the findings in August and still had not received a reply. He said he believed the HSE's investigation was not sufficiently comprehensive to provide "a well-grounded and fair assessment". He asked the HSE to reconsider its conclusions.
Last week, the HSE suspended new admissions to this and a number of other homes until certain concerns were addressed.
The HSE reports concerning Mrs Reynolds found there was only one nurse and two care staff caring for 47 patients on the night she left the home. The nurse was also working with the GP who was visiting an ill resident at the time.
Anne Costello, the home's director of care, agreed with the inspectors that it was a busy evening as families were returning residents to the home after the Christmas festivities. The inspectors found that the nursing home had no documentation for Mrs Reynolds's care on that night, apart from recording her return to the home at 8.30pm and the administration of her medication an hour later.
The inspectors wrote: "As Mrs Maura Reynolds had been described as a high risk patient by Ms Anne Costello . . . following her discussion by phone with Mrs Priscilla Reynolds on 4th November 2005 . . . the following actions should be taken: escorted to bed by a member of staff, cot sides erected on her bed, two hourly checks carried out, door to her bedroom left open". Ms Costello said some of these measures were carried out.
Mrs Reynolds's family had complained about her care weeks before she disappeared after her daughter-in-law, Priscilla, made an unscheduled visit to the home. In a written complaint to the HSE in February, Priscilla Reynolds outlined the concerns she raised in November. She said her mother-in-law had been in a distressed state, her face was injured after a fall, she had an ulcer on her foot and her feet were swollen.
Her toenails were "extraordinarily long and yellow" and she was concerned about tumours on her back. She witnessed her mother-in-law being given pain medication but this later fell from her mouth after the nurse had left. The inspection report says: "The practice of a nurse ensuring that Ms Maura Reynolds had swallowed her medication was discussed. The complaint in relation to pain management was upheld."
HSE inspectors found there was not a sufficient number of staff on duty at the time of the November visit. The complaint relating to the condition of the patient's foot ulcer was upheld and inspectors found she did not receive all the chiropody treatments she was entitled to. Inspectors found no evidence that her care plan had been updated following a risk assessment in response to her falls.