Close to 20 publicly-funded community and nursing home facilities were identified as “centres of concern” for infection control by the Health Information and Quality Authority (HIQA) at the outset of the Covid-19 outbreak, five of which were located in Co Cork.
Documents furnished to the Oireachtas Committee on Covid-19 detail the location of 19 long-term care centres deemed “high risk” for the spread of Covid-19 due to multiroom occupancy and shared facilities.
The physical premises and number of residents created “a situation where isolation for the purpose of preventing the spread of infection is extremely difficult and nearly impossible”, HIQA noted.
The facilities accommodated 1,269 residents in mid-March; 16 were HSE-run and three were HSE-funded services.
Five of the facilities were based in County Cork, including St Finbarr's Hospital and community hospitals in Clonakilty, Midleton, Macroom and Kanturk.
Parts of the Clonakilty community facility were high risk, including 28 beds, while other units lacked day space but had sizeable bays, an assessment found.
At Macroom Community Hospital the "entire centre" was deemed high risk because of the close proximity of beds and a lack of sanitary facilities.
At Leopardstown Park Hospital in Dublin some rooms had 10 residents and more sharing, making isolation "impossible".
The HSE subsequently advised the Department of Health that all of the facilities identified were included in plans for redevelopment.
“Progress has been made to enhance these environments with the addition of extensions as well as refurbishments and the replacement of older buildings with new builds,” HSE Chief Clinical Officer Dr Colm Henry advised on April 22.
Dr Henry confirmed three new centres replaced accommodation in Dublin and Waterford while St Patrick’s Hospital in Tipperary and St Finbarr's Hospital and Midleton Community Hospital in Cork will be replaced in 2022.
The remaining centres will be prioritised for redevelopment under a capital programme, he added.
While capacity was reduced or residents were transferred in five centres identified, the remaining centres continue to operate, HIQA has confirmed.
A spokesperson for the health watchdog said "risk-based" inspections are being carried out.
“While the number of residents in some centres may have reduced, HIQA has not received any information to advise that the risks in these centres have been addressed," it said. "A programme of risk-based inspections of nursing homes is currently underway and the reports will be published at www.hiqa.ie in due course.”
The HSE said no facilities were currently categorised as 'high risk'.
A spokesperson for the HSE said: "The HSE established a series of Covid Response Teams across all Community Healthcare Organisations (CHO) to support residents at all residential settings during the pandemic.
"These teams undertake analysis of the risk associated with residential settings and also report no current HSE locations as being centres of high concern."