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Nursing Homes

Nursing home complaints: 'Window visits not being permitted' and other Covid concerns

The allegations are contained in documents released to The Journal under the Freedom of Information Act.

AS THE COVID-19 crisis rumbled on last year, multiple allegations were made regarding a lack of social distancing, staff not adhering to guidelines and visitation issues in nursing homes across Ireland.

Further complaints were also raised throughout 2021 regarding alleged abuse, unexplained injuries and poor hygiene standards in nursing homes. 

That’s according to documents released to under the Freedom of Information Act.

Between 1 January and 1 October 2021, the Health Information and Quality Authority (Hiqa) received almost 800 pieces of information raising issues of concern in relation to older persons’ services in Ireland. 

Hiqa is responsible for the monitoring, inspection and registration of designated centres for older people, such as nursing homes, in Ireland. 

The concerns are heavily redacted in places. All identifying material relating to the centres and people involved is removed, in order to respect their privacy.

Despite this, the concerns give a real glimpse into the issues in residential care centres and nursing homes across Ireland, at a time when a spotlight has been shone on the sector as a result of the Covid-19 pandemic.

Nursing homes have been badly affected by the Covid-19 crisis.

Between the beginning of May, when the fourth wave of the virus hit Ireland, and early December, there had been 149 clusters – defined as a location where two or more cases have been confirmed – reported in nursing homes.

Nonetheless, the rollout of the vaccination and booster campaign has seen a significant improvement on the situation in nursing homes across the country, with visitation rules widely relaxed.

Covid-19 complaints

While visitation guidelines were eased throughout the year following guidance from the HPSC, many people contacted Hiqa expressing concern about such guidance not being adhered to. 

Between January and February, five complaints were made alleging that window visits were not being permitted. One of these complainants also alleged that they were “not being facilitated to contact their relative by video call” either. 

One person expressed their concern over the “negative impact” this would have on residents. 

The complaints were made despite Health Minister Stephen Donnelly in September 2020 contacting the HSE, Nursing Homes Ireland and Hiqa to make clear that window visits in nursing homes were not to be suspended.

On 22 March, restrictions on nursing homes were eased, allowing residents to have two visits per week if 80% of staff and residents were vaccinated against Covid-19. The restrictions eased again on 22 April, allowing four visits per week. 

As of 9 July, routine visiting no longer needed to be scheduled in advance and there was to be no time limit on duration of stays for visitors.

Despite the repeated easing of restrictions, throughout the year dozens of complaints were made to Hiqa over visiting guidance not being implemented. 

For example, in March, one person expressed concern over indoor visits not being facilitated and “the impact this is having on residents”.

Visitation issues weren’t the only Covid-related complaints people had this year, with numerous complaints being made about staff. 

In March, someone raised concerns “regarding an employee’s social media account supporting an anti-mask culture and not supporting Covid-19 guidance”. 

Another complaint in the same month alleged that “not all staff are wearing their face masks appropriately”. 

In May, one person raised concerns “about infection prevention and control measures, including staff not adhering to social distancing guidelines”. 

Back in February, another person contacted Hiqa with concerns over “renovations being carried out during Covid-19 Level 5 restrictions”.

Abuse concerns

Over the course of 2021, Hiqa was contacted hundreds of times with other non-Covid concerns. 

A number of people raised concerns over allegations of abuse. 

In January, one person contacted Hiqa with concerns about “the quality of care in relation to poor social interaction, personal hygiene, complaints management and allegations of abuse”. 

Another person, in April, raised concerns about “the safeguarding of residents and management of an allegation of abuse”. 

The same month, someone contact Hiqa concerned about “an allegation of financial abuse”. 

In June, one person raised concerns about “safeguarding in relation to unexplained bruising”. 

Other complaints

Hiqa was also contacted on multiple occasions with people raising concerns over hygiene standards, nutritional standards, infection prevention and poor governance, among other issues. 

One person contacted Hiqa in January with concerns about “the quality of care and welfare of residents, including safeguarding, call bells being unanswered, staff attitudes and poor governance and management”. 

Another person, in January, raised concerns about “poor personal hygiene, food and nutrition”. 

In February, a concern was raised about “infection prevention and control practices, including decontamination of equipment, and wound management”. 

Throughout 2021, there were also numerous concerns raised about the standards of the nursing home buildings in Ireland. 

One person, in January, raised concerns about “sewerage and water leakages” from a nursing home. 

Another person contacted Hiqa in February with concerns about “lack of ventilation”. 

The same month, someone raised “health and safety” concerns over the lift in a centre being “out of service”. 

Hiqa response 

Hiqa does not have a remit to investigate individual complaints. However, all unsolicited information, which can be received from anyone concerned about a centre, is used to inform the watchdog’s monitoring of each residential centre.

Hiqa monitors and inspects designated centres for older people, such as nursing homes, against regulation and standards.

“The aim of the Health Information and Quality Authority is to advance high-quality and safe care for people accessing health and social care services in Ireland,” a spokesperson for Hiqa said in a statement to The Journal.

“Where Hiqa has concerns related to the safety of residents and the quality of care that they are receiving, providers are required to take immediate action to address their,” they said.

The spokesperson said Hiqa inspectors follow up with providers to “ensure that the actions are being implemented and are resulting in improvements for residents”.

“Where there are risks to the safety of residents or where the provider has failed to address areas of concern repeatedly, Hiqa can take escalated action, up to and including court action to cancel the registration of the centre,” they said.

Our colleagues at Noteworthy want to investigate if there is an overprescription problem in our nursing homes. Support this project here.

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