BEAUMONT CRITICISED:STAFF AT Dublin's Beaumont Hospital were witnessing a recurring pattern of residents being admitted from Leas Cross nursing home with problems "that either were or could be indicators of poor care at the home", the commission of investigation found.
Its report said these problems included pressure sores, dehydration and urinary tract infections, but it seemed the hospital’s staff did not report these to the former Northern Area Health Board (NAHB) or the HSE.
The report adds that a number of families of former residents in the nursing home said nurses and doctors and even a consultant at Beaumont had expressed concerns to them about care at the home after their relatives were taken to the hospital, but it seemed they “did not convey any of their concerns about Leas Cross to the health board or to the HSE”.
The report says: “There is no doubt that the absence of any formal procedure for recording and reporting such concerns within the hospital contributed to the failure to identify and respond to the emerging pattern of care problems at Leas Cross. However, the fact that there was no formal procedure does not, in the commission’s opinion, absolve the hospital’s medical staff from fulfilling their duty of care to their patients. In the commission’s view, such duty of care must include a duty to report, and if necessary to follow up on, any concerns which they have regarding the care afforded to patients in the nursing home from which those patients have been admitted.”
It added that the nursing home regulations allow a formal complaint to be made to the health board/HSE by any person acting on behalf of a nursing home resident. It said Beaumont had submitted that the health board/HSE had refused to accept complaints from the hospital’s social work department unless they were made with the consent of the patient concerned or their family.
“However, the key issue here is not that the complaints of Beaumont staff about Leas Cross were rejected, but that, prior to the introduction of a formal reporting system in 2005, there is no evidence of such complaints being made in the first place,” the report goes on.
Meanwhile, the report notes that Beaumont Hospital itself as well as the Mater hospital, also sent patients to Leas Cross to free up beds.
About 75 to 80 patients were discharged to the home from the Mater between October 1998 and February 2005. Some were sent only for respite.
The commission was told by the Mater it did not advocate Leas Cross over any other private nursing home, but it was on an approved list compiled by the then NAHB.
The report says the majority of Leas Cross patients who required admission to hospital went to Beaumont rather than the Mater. Therefore staff at the Mater “did not have many opportunities to observe the standard of care given to Leas Cross residents”.
Meanwhile, the report says the commission of investigation considers that the question of the extent to which hospitals can and should follow up frail, elderly patients discharged to nursing homes is one that warrants further consideration by the hospitals themselves and by the HSE.
In a statement last night Beaumont Hospital said it was clear that patients suffered poor care within Leas Cross and Beaumont regretted that the difficulties at Leas Cross were not identified sooner. It added: “Beaumont’s emergency department typically sees close to 1,000 patients a week – a significant proportion of these being elderly and coming from a large number of public and private nursing homes. In such circumstances identifying trends of poor care in individual institutions over a period of years can be extremely difficult.
“The hospital welcomes the way the report highlights the importance of ensuring continuity of care following discharge from acute hospitals to other settings – whether that be to public or private nursing homes or, indeed, back to private residences.”