Covid-19 shows nursing home regulations are outdated - HIQA

Covid-19 shows nursing home regulations are outdated - HIQA
Mary Dunnion (right), with Phelim Quinn, said infection prevention and control in nursing homes falls short of what is needed to respond to the coronavirus pandemic. Photo: Collins

Regulations governing nursing homes are outdated and must be changed to make them fit for purpose, the State’s health services watchdog has urged.

A report from the Health Information and Quality Authority (HIQA) on the impact of Covid-19 on nursing homes found major shortcomings in governance, staffing and infection prevention and control.

HIQA’s chief inspector of social services and director of regulation, Mary Dunnion, said Covid-19 brought into sharp focus the need for reform of current models of care for older people.

In particular, the current regulation on infection prevention and control in nursing homes falls short of what is needed to respond and manage a Covid-19 outbreak.

“The continued use of multi-occupancy rooms and outmoded premises in some nursing homes undoubtedly created challenges in containing the spread of infections," said Ms Dunnion.

“We must look to complementary models of care, such as home care and assisted living, and ensure that there is improved clinical outsight in all nursing homes.

Furthermore, the regulations governing nursing homes are outdated and must be revised to make them fit for purpose, particularly as regards governance, staffing numbers, skill-mix and infection prevention and control.

Ms Dunnion said HIQA would continue to listen to the experiences of residents, relatives and staff to strive for safer, better care that focuses on the human rights and individual needs of the person.

Throughout the public health emergency, HIQA continued to regulate nursing homes. While onsite inspections were suspended the authority kept in regular contact with providers and managers.

Residents in nursing homes also spoke to inspectors and while they were very upset because of the visiting restrictions all were deeply grateful to staff for the care they provided in very challenging circumstances.

Some relatives experienced poor communication with nursing homes and that only served to heighten their anxiety. Others raised concerns about the adherence to public health guidelines and the appropriate use of personal protective equipment.

When the report was published there were 576 registered nursing homes in Ireland, with around 32,000 residential places. Most nursing homes are privately owned and account for eight-out-of-10 beds.

HIQA took several initiatives to ensure the safety and welfare of residents and to support service providers and staff from the outset of the pandemic.

In particular, all nursing homes were telephoned every fortnight by an inspector of social services and from March 25 until the time of writing the report, 2,852 phone calls were made to nursing homes.

Ms Dunnion said many nursing homes were fortunate not to have an outbreak of Covid-19 to date and many of the issues encountered by providers at the time of preparing the report had been resolved.

At the time of preparing the report, half the centres (51%) had reported a confirmed case of Covid-19 while 9% of centres had reported a suspected case and 40% of centres had reported no outbreak.

However, there was a high rate of failure to comply with the governance and management in some centres and Ms Dunnion believes that might have contributed to more severe outbreaks.

More in this section

Lunchtime News Wrap

A lunchtime summary of content highlights on the Irish Examiner website. Delivered at 1pm each day.

Sign up