‘Significant improvements’ are reported by the Health Information and Quality Authority (HIQA) following an unannounced inspection of Dealgan House Nursing Home on September 8.
While the private run nursing home at Bellewsbridge Road can cater for 84 residents, there were 58 residents at the time of the inspection.
The report, which was published on the HIQA website last week, states: ‘Overall there were significant improvements since the last inspection and the management and oversight arrangements had improved. The improvements were also evidenced by the very positive feedback that was received from residents and their families during the inspection.’
The report outlines how the inspectors spoke with residents about their experience of living in the centre. Residents looked relaxed and comfortable and described the centre as their ‘home’. They said that they felt safe and well-cared for and that staff did their very best to ensure that they had everything they required. Residents reported that staff had time to listen to them and to reassure them. Residents were very appreciative of the staff’s efforts to keep them safe.
While all residents reported that they were happy and content living in the centre, some residents mentioned the negative impact the ongoing media interest following the COVID-19 outbreak earlier in the year, had had on their well being. This was also echoed by staff and the many visitors who met the inspectors on the day. Inspectors met with eight relatives and visitors who were unanimous in their satisfaction with the quality of care provided to their loved ones and their confidence in the service.
Staff also described how difficult the last few months had been, and that despite the constant negative attention they enjoyed working in the centre. Staff told the inspectors that they were supported by management and were proud of the high standard of care that they provided to the residents.
The report states: ‘Staff expressed genuine empathy and care about the residents they looked after and described the impact of the current restrictions on the residents, and how uplifted the residents were that social activities had resumed.
The inspectors saw residents enjoying the fresh air in the garden while others watched a movie. Staff in the dementia unit were observed using tongs and curlers to groom ladies’ hair, and it was noted that the residents there were enjoying the chat and atmosphere similar to a hair salon..
At the time of the inspection, visiting has also resumed and there was praise for the measures which had put in place to allow this to take place safely.
It was also noted that there was increased training, better staff supervision, improved communication and accessible staff support
However, while improvements had been made in respect of governance and management of clinical areas, the report said that further improvements were required in areas such as maintenance, administration, health and safety, including infection prevention and control and risk management. The management and oversight of these areas was not robust which was reflected in findings of non-compliances.
The report also found that: ‘The staffing levels had improved since the last inspection and there were sufficient staff with the appropriate knowledge and skills to meet the needs of the residents. Where agency staff were used the provider sourced staff who were familiar with the centre and who had received a thorough induction to their roles and the standards that were required of them.’
Staff demonstrated a positive attitude to their work and were clear about their roles and responsibilities and the standards that were expected of them.
New staff were given training in health and safety and infection prevention and control as part of the induction and staff were observed adhering to infection prevention and control practices such as the uniform policy, monitoring staff temperatures arriving and during the working day, good hand hygiene practices and social distancing measures at break times
Inspectors found that there were sufficient nursing and care staff with the appropriate knowledge and skills to provide safe care for the residents taking into account the size and layout of the designated centre. There was a qualified nurse on duty at all times on each unit in the centre. Current nursing staff levels ensured there was no movement of staff between units.
However, the nursing home was found to be non-compliant in regard to record keeping and staff rosters, and the inspection also found that further improvements were required in respect of promoting and maintaining a safe environment, specifically in respect of health and safety, risk management and infection control measure.
Local TDs repeat call for public inquiry
Local TDs Fergus O’Dowd and Ruairí Ó Murchú have renewed their calls for an inquiry into the circumstances which led to the deaths of 22 residents of Dealgan House Nursing Home during the first wave of the COVID-19 pandemic earlier this year.
Health Minister Stephen Donnelly stated during the debate on the Final Report of the Special Committee on COVID-19 Response in the Dáil last Thursday that he had met some bereaved families and they were looking for answers. ‘They deserve answers. Many factors have to be considered, I am looking at the best way to get them the answers they want, need and deserve.’
Fine Gael’s Deputy O’Dowd said he feared that the threat posed by the virus is growing. ‘COVID is again stalking, regrettably and sadly, our nursing homes.’
He drew attention to HIQA inspection reports which highlighted that just over one third of during homes are not compliant with the regulations.
‘Many of those who work in nursing homes are poorly paid and have poor conditions of service,’ he noted. ‘Many of them are recent immigrants and have no proper sick pay. They are vulnerable workers, have poor accommodation and many of them have to work in more than one location to make a living.’
He also pointed out that ‘nursing home owners are well paid and the top 12 or 13 make hundreds of millions of euro every year.’
‘It is interesting that 22 nursing homes changed hands in the past year, and it is people from outside of Ireland coming here to invest in the industry. That raises a big red flag for me. I agree with the view that we cannot allow the privatisation of nursing homes and care of the elderly to continue. We must reverse that, as we are doing with respect to housing, and ensure that the HSE and the State step in. We cannot have the exploitation of people, as is happening in what I accept is a small minority of nursing homes.’
Deputy O’Dowd voiced his concern at the fact at the increase of COVID-19 cases.
‘We are at a very difficult point and must fully ensure that no effort is spared in helping these people, particularly in nursing homes.’ He also noted that there was ‘a very significant increase in mental health issues’ and that ‘the incidence of dementia, depression and anxiety among residents has increased exponentially.’
Pointing out that Dealgan House was ‘the only nursing home where there were practically no staff in place because most were out sick or had left,’ he said ‘There must be an inquiry into Dealgan nursing home.
‘Awful things happened there and the families need the truth about it. The truth must be found for them and I believe the Minister of State is committed to finding it. What happened is entirely unacceptable. We have talked about it before and we will talk about it again. I urge the Minister of State, if she can, to tell us what she is going to do about it. It is three weeks since we had the meeting about it and the families want an investigation into what happened.’
‘The country has come a long way and we are now at a crossroads. The danger is that the virus is on the rise again. Our nursing home residents are extremely vulnerable in the short, dark, dank days and long nights we are facing into now. I urge absolute vigilance at this time of serious risk for people. In particular, there must be more action and greater commitment
Deputy Ó Murchú said he was aware that the Minister has met the families who had lost loved ones in Dealgan House and that ‘he is looking for a formula or mechanism – I do not want to put words in his mouth – for giving people the answers they need.’
‘That is vital. It is important that it happen as soon as possible,’ he continued.
‘Obviously, the families’ ask is for a public inquiry,’ he said describing them as ‘very tenacious’.