Significant improvements were still required at a HSE-run Co Cork care home to segregate residents five months after a severe Covid-19 outbreak, a State health inspector has said.
Health service watchdog, the Health Information and Quality Authority, found that in October – four months after a post-outbreak inspection of Clonakilty Community Hospital – the home still did not have available assigned space where it could isolate residents that tested positive for Covid-19.
The regulator raised concerns during a June inspection that residents at the west Cork facility, home to 77 people, had not been appropriately segregated during a large Covid-19 outbreak.
Ten residents died during the outbreak in the first wave of the pandemic in April and May.
When a Hiqa inspector returned to the HSE’s facility in October, he found that one care unit identified as a location for isolating Covid-positive residents was not available for use and that another potential isolation unit had not yet been renovated and also could not be used.
The care facility was told to complete a review of the outbreak “as a matter of urgency” to ensure it was “better prepared to protect residents in the event of a second outbreak of Covid-19”.
On the day of the inspection, Hiqa found a small number of isolation rooms within the care home but there was “no other accommodation available on that day to effect a timely response to a new outbreak of Covid-19 which would allow immediate isolation and cohorting of residents”.
The regulator and the HSE have been at odds for more than four years over the suitability of multi-bed rooms at the facility which dates back to the 1800s. The HSE took a legal action against Hiqa over restrictions applied on the number of residents it could take but this was later dropped.
The latest findings about the Cork home were contained in one of 53 inspection reports published by the health watchdog that found non-compliance with regulations at 32 care facilities.
The regulator raised concerns that incidents, including allegations of abuse, at Mount Carmel Community Hospital in Churchtown, Dublin – owned by the HSE and operated by Mowlam Healthcare – were "not picked up by staff or management".
Hiqa found during an inspection last November that this meant there was “a failure to respond in a timely manner to ensure all residents were safeguarded”.
Since January 2020, Hiqa’s chief inceptor had received 10 pieces of unsolicited information concerning Mount Carmel, of which five concerned allegations of poor care.
The regulator found a high attrition rate among clinical staff with 23 per cent of staff nurses and 63 per cent of healthcare assistants leaving the care facility over the previous year.
The home was found to be not in compliance with four healthcare regulations.
During a Covid-19 outbreak between April and June 2020, 38 residents contracted the virus at the care facility and seven died after being transferred to hospitals.
Another inspection report revealed that St Joseph's Nursing Home in Virginia, Co Cavan, suffered a severe outbreak during the third wave last January that resulted in the deaths of 13 residents, about a quarter of the residents living there.
There were 37 residents and 36 staff members infected during the outbreak.
The inspector found during a visit in March that there were not enough staff to meet the needs of residents and that residents requiring supervision were left unsupervised for long periods.
There were only two housekeepers on duty, although the centre was still dealing with a Covid-19 outbreak and accommodation was spread across three floors.
Another outbreak at St Joseph's Hospital in Ennis, Co Clare, during the third wave between December and February led to the deaths of six residents and a further 26 becoming infected.
A private nursing home, Rivervale near Nenagh, Co Tipperary, was found to have only one staff nurse on duty from 4pm to 8am to meet the needs of "highly dependent residents".
In the context of the Covid-19 crisis, this was “not appropriate”, the regulator said.
In a “significant incident” at Orwell Private nursing home in Dublin, an inspector found that in one part of the home, residents were left without staffing support, meals and medication from 8am to 2pm, which “significantly increased the risk to safety for residents”.