How Kerry nursing home residents were failed, and how we can stop it from happening again

Spotlight on Hiqa after eight residents died in three weeks; regulator first flagged up Oaklands as far back as March
How Kerry nursing home residents were failed, and how we can stop it from happening again

Oaklands Nursing Home: Hiqa finally obtained an order at Kerry District Court cancelling Bolden (Nursing) Ltd’s designated centre registration last week.

"What did we learn?"

It's a simple question, one asked by bereaved brother Gerry Kennedy this week.  

Mr Kennedy was speaking to the Irish Examiner after the death from Covid-19 of his brother Seán in a Kerry nursing home.  

The Oaklands Nursing Home in Derry, just outside Listowel, has been at the centre of a tragedy: In the past three weeks, eight residents, including Seán, have died after contracting the virus there. 

While some of the home’s remaining 23 residents are now recovering, at least two are in a critical condition.

Around 1,000 nursing home residents have died of Covid-19 throughout the country during the pandemic.

Senior figures in the HSE, Health Information and Quality Authority (Hiqa), and Department of Health have been called before politicians demanding answers. 

A special cross-party Oireachtas committee examining the State’s response to the pandemic acknowledged the virus was “most deadly” in nursing homes. A contributing factor, it said, is the “fragmented relationship” between public health authorities and private nursing homes.

Committee members concluded the overall model of care for older people was “deeply flawed”. They recommended the integration of private nursing homes into the wider framework of public health and social care.

Other recommendations included an urgent review by the Department of Health of clinical oversight and governance arrangements in private nursing homes. The committee's report also recommended strengthening Hiqa's powers. 

So after all that very obvious signalling in public about what some of the problems — and solutions — are, people could have been forgiven for thinking the matter was being sufficiently handled.

How wrong they were.

And,  yet again, at the heart of the latest deadly Covid-19 cluster is Hiqa.

Under fire from relatives of residents at Oaklands, it has since insisted it repeatedly flagged up issues there.

Writing in Thursday's Irish Examiner, Hiqa chief inspector Mary Dunnion appealed again for her organisation to be given those powers to act faster in order to protect our most vulnerable population. 

This latest nursing home crisis was hardly a dirty little secret shared only between the owners of Oaklands Nursing Home and Hiqa.

Indeed, the Irish Examiner has learned that the regulator first flagged up Oaklands to the Department of Health and the HSE as far back as March. 

It had warned there were 212 residential care facilities for the elderly  “deemed to be at risk” in the pandemic.

The relatives of residents at Oaklands didn’t know it was on the list. And one of the reasons why they didn’t know was because Hiqa was instructed not to publish the list.

Indeed, the relatives only appear to have found out there was a major problem when they read news reports last Thursday that its registration had been cancelled.

Relatives simply do not understand how the home, which charged each resident around €4,000-a-month, was allowed to operate.

They believe action to shut the home down should have been taken long ago, maybe as far back as 2018. This was when one inspection discovered the home was in breach of every single regulation for which it was inspected.

The regulator first flagged up Oaklands to the Department of Health and the HSE as far back as March. Picture Dan Linehan
The regulator first flagged up Oaklands to the Department of Health and the HSE as far back as March. Picture Dan Linehan

On June 18, inspectors discovered that as well as being in breach of infection control regulations, there was nobody actually in charge of the home.

Despite a long history of non-compliance with some of the most basic regulations, Oaklands' registration was only cancelled last week.

Hiqa finally obtained an order at Kerry District Court cancelling Bolden (Nursing) Ltd’s designated centre registration last week.

But questions remain about why it wasn’t until six people had died that the order was obtained.

“Action was taken too little and too late,” said Gerry, whose 77-year-old brother Seán died of Covid-19 on Friday, November 13, at the home.

I cannot understand why action was not taken sooner. There needs to be an investigation into the role Hiqa played here.

“If the Food Safety Authority found a restaurant was not compliant, it would close it down immediately.

“What did we learn over the year? We don’t appear to have learned anything.”

The HSE says any issues to do with regulation should be put to Hiqa.

Hiqa maintains it does not have the power to move fast enough against nursing homes. It has flagged this up with the previous health minister, Simon Harris, and his successor, Stephen Donnelly.

Indeed, what people don't realise is that nursing home owners can not only stall Hiqa actions against them for years, but they can also stop Hiqa publishing critical reports about them.

Clearly, knowing what the problems are in our nursing homes is not enough.

We have learned that it appears to be easier to shut down a restaurant than it is to shut down a nursing home for the elderly.

So while we might appreciate the anguish in Mr Kennedy’s question, and we know what we have learned, knowing when anything will be done about what we have learned is an entirely different matter.

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