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HIQA’s board suggested at the beginning of April that consideration should be given to highlighting living arrangements for nursing home staff so that shared accommodation is avoided.
At its meeting on 6 April, the minutes of which were seen by the Medical Independent, Deputy Chief Inspector for Older Person’s Services Ms Susan Cliffe set out the main challenges for nursing homes including lack of access to personal protective equipment (PPE), lack of access to rapid testing for staff working in the nursing homes and lack of access to prompt test results.
Ms Cliffe also explained that the staff profile of those working in nursing homes is a factor in that many live in shared accommodation, some are sourced through employment agencies, and some may work in a number of different facilities.
“These factors impact on staff continuity and reliability and on the safety of the residents,” she said.
HIQA CEO Mr Phelim Quinn, who sits on the national public health emergency team (NPHET), advised that these issues have been brought to the attention of NPHET and has prompted the range of measures announced by the Government.
Mr Quinn explained that shortly after the start of the outbreak, HIQA identified specific weaknesses in the system where some nursing homes were struggling to maintain safe services in the context of Covid-19.
The Authority’s Director of Regulation Ms Mary Dunnion outlined key issues within the sector and explained that a large volume of nursing home provision is provided by private providers.
“While HSE services are supported by the HSE, the private sector is at a remove from the HSE and therefore there had been limited initial alignment with the national management plan,” it was stated.
Ms Dunnion has acted as a conduit between private nursing home providers and key officials within
the HSE on the matter.
It was also noted that “many of the contributing factors to the current situation had been previously escalated to the HSE and the Department of Health” and “issues relating to compliance with and relevance of regulations and the Health Act had been escalated previously”.
The board suggested that full support and contribution to the NPHET should be maintained but that consideration be given to communicating directly with the Minister, in addition to NPHET, regarding immediate requirements for nursing homes, such as PPE, staff testing, and prompt results.
This would be in recognition of this sector being a frontline service.