Coronavirus: Staff shortages and test delays fuelled Dundalk home outbreak

Testing delays and staff shortages exacerbated a major coronavirus outbreak in a privately run Dundalk nursing home, which has seen 23 residents die since early April, mostly from Covid-19.

Dealgan House is an 84-bed private nursing home in Dundalk, Co Louth, and one of the worst hit care homes in the country.

Internal correspondence, seen by The Irish Times, shows management at the home cited testing delays, staff shortages, and a lack of personal protective equipment (PPE) as key factors behind the outbreak.

Despite several appeals for PPE gear throughout March the privately run home did not receive any shipments from the HSE until after their first confirmed case in early April.

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On March 6th, Nursing Homes Ireland (NHI), which represents private and voluntary nursing homes, advised facilities to ban visitors. Dealgan House limited residents to one visitor per day, but did not impose a full ban until March 13th.

Tom Mulholland (84) was one of the 23 residents in the care home who died in the past five weeks.

“We’d be in an awful lot, he had at least three visitors a day, once they went into lockdown it was very hard to get in touch,” his daughter Roisin Duffy told The Irish Times.

In the week after the facility had its first Covid-19 case on April 4th the family “heard nothing” about Mr Mulholland’s condition. “You could call maybe seven times and not get through,” Ms Duffy said.

By April 10th, three residents had tested positive for Covid-19, with several others showing symptoms.

Eoin Farrelly, managing director, told relatives in a written update that test results were "very slow" coming back. "The absence of testing for staff showing symptoms has been a major difficulty," he said, as staff were out of work for 14 days self-isolating.

“During March we ordered and stockpiled as much PPE as we were able to get,” but sourcing medical grade gear was difficult, the correspondence said.

The home did not receive PPE from the HSE “despite multiple orders” until after the first case on April 4th, he said.

Late on April 12th, the Mulholland family received a call to inform them an ambulance had been called for their father, and six of the eight siblings rushed to the home to see the ambulance take him out.

“He looked so poorly, all masked up. I will never ever get that image out of my head,” Ms Duffy said.

The following Tuesday he tested positive for Covid-19 in Our Lady of Lourdes Hospital, Drogheda, and was being treated for kidney failure.

Margaret Mulholland (76), his wife of over 50 years, was unable to visit him in the hospital and he died on April 20th.

There was a “lack of communication” about the scale of the outbreak and the deterioration in her father’s condition, Ms Duffy said.

“There’s no blame game here, it’s gone beyond that, we want to know the sequence of how it happened,” she said.

In an email to relatives on April 17th, Mr Farrelly said the absence of key management staff due to Covid-19 had “affected our communication capacity.”

The outbreak had affected a “significant proportion” of staff, with remaining workers focused on caring for residents.

At that stage Dealgan House was receiving “significant assistance from the HSE to address the staffing and equipment constraints,” he said.

Management believed the outbreak had "passed the worst point" and was being brought under control, he said. However, later that day the Royal College of Surgeons (RCSI) Hospital Group took over the running of the facility.

Mr Farrelly was unavailable for interview. On Thursday he issued a statement saying Dealgan House “offers our sincere sympathies” to the families of the 23 residents who had died.

The support of additional personnel from RCSI would be “wound down gradually” as the nursing home’s staff returned to work, he said.

The Health Information and Quality Authority (Hiqa) announced on Friday it would be conducted an inspection of Dealgan House “in the near future”.