Standards of care fell below acceptable levels

STANDARDS of care fell below acceptable levels at Leas Cross Nursing Home for nearly two years before it closed in 2005, the final report of the Government-appointed inquiry has concluded.

The facility in north Co Dublin closed in August 2005 following an undercover RTÉ Prime Time Investigates TV programme that raised concerns over the treatment of its residents.

It later emerged that 105 patients died at the nursing home between 2002 and 2004, many showing symptoms of grave neglect, such as bed sores, dehydration and malnutrition.

The Commission of Investigation found that the number of competent staff was insufficient to provide the necessary standard of nursing care.

The ratio of nursing staff to care attendants was inadequate and there was evidence that many care attendants lacked appropriate training. An inspector who visited the home in April 2005 described the deficit in nursing staff as the worst he had encountered.

The commission, established in April 2007, with barrister Diarmuid O’Donovan as sole member, investigated the management, operation and supervision of the nursing home.

Leas Cross opened in 1998 with 38 beds and expanded to an 111-bed facility in 2002.

Over the following two years, there was a significant increase in the number of frail, high-dependency patients admitted to the home.

The inquiry criticised the health authority for failing to examine whether the nursing home could cope with this increase.

The health board also failed to monitor developments at the nursing home more closely once registration had been granted.

It also appeared that once registration of Leas Cross had expired, it was reviewed automatically, with no regard to its suitability.

And re-registration took place in June 2004 when the health authority and inspectors were aware of a serious complaint.

The inquiry said the practice of the health board seriously undermined the inspection process and potentially posed serious risks for the residents of nursing homes.

The report also found that the health authority had detailed information regarding Leas Cross covering a number of years, that included evidence of recurring problems.

“Taken as a whole, this accumulated evidence should have alerted the health board/HSE to impending problems, which could have been avoided,” the inquiry states.

The inquiry was also critical of staff at Beaumont Hospital for not raising concerns about Leas Cross.

Even though the hospital had no formal reporting procedure in place when patients from the home were admitted, staff still had a duty to report any concerns they might have regarding their care.

The HSE said it fully accepted all of the commission’s finding.

Health Minister Mary Harney said the report was balanced, comprehensive and insightful and hoped it would bring closure to the families affected by the events.