THE COMMISSION of investigation report into Leas Cross nursing home makes for shocking reading. For one, it provides a window into the appalling deficits of care provided to elderly residents. But above all, it illustrates the extent of the systemic and institutional failures across the inspections regime for older people in care. There is no reason to believe these deficits were confined to Leas Cross. Instead, given the structure of the health service and the lack of independent inspections, it is likely these conditions were replicated in many long-stay care settings across the State.
The root of the problem at Leas Cross was when the local health authority – the Northern Area Health Board – allowed it to register an additional 73 beds in 2002, bringing it from a 38 to an 111-bed home. As the commission report makes clear, the health board failed to impose conditions to ensure it had sufficient staff to cope. Yet these new residents were the most vulnerable of all, suffering in many cases from dementia and Alzheimer’s, and required intensive and trained nursing care. However, staffing levels remained the same. Inevitably, complaints over the standards of care followed. When the issue of registration came up again in 2004, it was re-registered by the health board, before actually investigating one particularly serious complaint.
At the same time, the nursing home received several million euro from local health boards in respect of subventions and payments for badly-needed contract beds. It is clear that this conflict of interest – in which health authorities were inspecting the same nursing homes which it funded – placed residents at serious risk. It should not come as a surprise to us. After all, the Ryan report on industrial schools showed in graphic terms how mistreatment can flourish in an environment where vulnerable people do not receive the kind of protection and oversight they need.
Under a new system introduced since the beginning of July, all nursing homes, public and private, are finally subject to independent inspections by teams attached to the Health Information Quality Authority (Hiqa). A set of minimum standards applies to all residential settings that care for older people and for which registration is required.
While the standards will help deliver better quality care, it is unlikely they will rid the system of abuse. In Britain, where more robust standards and inspections have been in place for several years, there are still disturbing cases of abuse.
If anything, the commission’s report is a reminder that we cannot afford to neglect care standards for our most vulnerable citizens. Gaping flaws remain, such as the lack of inspections for thousands of disabled adults in outdated institutions care. Hundreds of intellectually disabled children remain in residential care where there are no minimum care standards. It is vital that the Government moves swiftly to introduce such safeguards, which have been talked about for years. Our most vulnerable citizens cannot afford to wait any longer.