Hiqa warned HSE about ‘high risk’ nursing homes, committee hears

The health service watchdog Hiqa has said it provided the HSE and the Department of Health with a list of “high risk” nursing homes at the outset of the Covid-19npandemic.

Hiqa chief inspector of social services Mary Dunnion told the Oireachtas committee on Covid-19 on Tuesday that the list set out premises that would find it challenging to manage an outbreak.

She said this would have been communicated to the HSE and the department in February or March.

“We went further than that. We took a look at particular types of nursing homes that would be at risk should there be a Covid outbreak.”

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“These, we would have determined, would be single, stand-alone providers and limited companies and also those that had regulatory non-compliance, not only with infection control but also with governance and management, risk management and staff training.”

Ms Dunnion told Social Democrats co-leader Róisín Shortall that Hiqa had received only an acknowledgement from the department on submission of its list.

Hiqa chief executive Phelim Quinn told the committee that the Covid-19 pandemic had exposed “a significant number of weaknesses within the system”.

Vulnerable

Mr Quinn said there was no national clinical oversight of the care being delivered to some of the country’s most vulnerable patients. Mr Quinn said Hiqa had raised on a number of occasions issues that it had about the current regulatory framework. It had submitted papers to the department as the policymaker.

He said Hiqa had not received specific responses but that the engagement was ongoing.

Ms Dunnion said Hiqa had written a fortnight ago to the Health Protection Surveillance Centre to see if it could secure public health guidance on how nursing home owners could “open their doors in a controlled manner with public health precautions so that families could come and see their loved ones”.

She said that was an ongoing issue and a decision had yet to be made, although the committee heard separately that the National Public Health Emergency Team (NPHET) may look at the matter later this week.

Ms Dunnion said Hiqa’s phoneline for the public to report concerns had received 28 notifications in March, 176 in April and 88 so far in May.

She told John McGuinness of Fianna Fáil that the concerns came from staff, families and nursing home residents.

“Predominantly the issue that staff have brought to our attention is the availability of personal protective equipment, testing, results and infection control, Families have raised significant issues around safeguarding, quality of care, communications, the impact of visiting restrictions and social isolation and sadly about the death of residents.

“Residents have contacted us directly and predominantly the areas they brought to our attention was isolation and not being able to see their families and the loneliness associated with that.”

Inspections

She said that since the beginning of March, Hiqa had conducted nearly 200 inspections of nursing homes. However, there have been no inspections in nursing homes where there have been Covid-19 outbreaks although the committee heard that some “risk inspections” were getting under way now.

Duncan Smith of the Labour Party said it was "concerning that no inspections have yet been carried out in any nursing homes that have had high outbreaks of Covid-19".

"There have been significant calls for Hiqa to carry out inspections in nursing homes such as Dealgan House in Louth and St Mary's in the Phoenix Park.

Hiqa told Ruairí Ó Murchú of Sinn Féin that it would be carrying out an inspection at Dealgan House on Wednesday.

Stephen Donnelly of Fianna Fáil saidMinister for Health Simon Harris had maintained that while the representative body for nursing homes was not a member of NPHET, Hiqa was the voice of the sector on that forum.

Mr Quinn said when Hiqa was appointed to the emergency team, there was no specific reference to it being the voice of this sector. He said it had a wide remit.