‘Failure to care for vulnerable people’

THE long-awaited Leas Cross nursing home report details how the home was deficient at many levels, including having “inadequate numbers of inadequately trained staff”.

While senior health board management did not appear to give “due weight” to written concerns by health workers, noted author Prof Des O’Neill in his draft report, questions remain over staff actions at the home.

Medical letters accompanied patients coming from hospitals or elsewhere when they arrived at Leas Cross’s door. However, there was “little evidence of any structured care planning” when it came to forms during the investigation into the 105 deaths at the Swords facility.

This was in addition to important basic data missing on patients’ files, Mr O’Neill’s inquiry found.

Around just 10% of residents checked had their weight recorded on arrival.

According to Mr O’Neill, this is a marker of the standard of care at a home. It can also indicate conditions of residents, like malnutrition. Only 14% of more than 100 residents noted during the investigation had skin conditions recorded on arrivals. This can indicate someone’s risk of developing pressure sores.

Mr O’Neill also noted there were further major failings in filling out forms.

In certain checks, only 87 out of 100 patients had medical histories registered and just 17 out of 100 residents’ eating habits were recorded during a check.

The draft report stated: “In particular, there were deficiencies noted in pressure sore prevention and care, assessment and management of swallow disorders, and in documenting the use and appropriateness of restraints which were indicative of a failure to adequately understand and progress care for these vulnerable people.”

One case which was highlighted was that of Dorothy Black. The Dublin City Coroner last year heard how the elderly woman died from massive bed sores which left gaping holes down to the bone after living in Leas Cross for a number of weeks. The 58-page draft report also notes the alarming number of residents who were being nursed in restraint chairs.

No written policy was laid down in forms for vaccination schedules.

Prof O’Neill’s report concludes: “It would be a very major error to presume that the deficits in care shown in Leas Cross represent an isolated incident. Rather, given the lack of structure, funding, standards and oversight, they are very likely to be replicated to a greater or lesser extent in institutions throughout the long-term care system in the country.”

He adds that this is not to deny the motivation of health workers and their dedication but rather it “represents the Government and the health system”.