Thursday 27 June 2019

HSE lapses leave residents in care homes vulnerable to fraud

Report shows some clients' nest eggs have not been given full protection

Tony O’Brien, director general of the HSE, signed off on the report which looked at publicly run care homes. Photo: Tom Burke
Tony O’Brien, director general of the HSE, signed off on the report which looked at publicly run care homes. Photo: Tom Burke
Eilish O'Regan

Eilish O'Regan

Funds held for vulnerable elderly people have been left open to fraud after staff in some HSE-run care homes withdrew from patient accounts without following proper rules.

A new report reveals the HSE is failing to fully protect parts of the €120m private "nest eggs" it is holding in safekeeping for elderly and other long-term residents.

Nearly 10,000 residents have private property including bank accounts, pension books, house documents, investments or jewellery left in the charge of the HSE.

However, an internal report reveals ongoing gaps in controls which leave some of the funds of vulnerable residents open to fraud. The report looks at publicly run care homes, and was signed off on by HSE chief Tony O'Brien.

Breaches uncovered show some care homes withdrawing from patient accounts without providing back-up documentation and proof of clearance.

"The operation of these controls was examined in a number of care centres as part of the audit of financial statements.

"The audit found the documentation specified had not been used in a number of cases, particularly in respect of payments to third parties on behalf of patients," it says.

"The HSE has on a number of occasions in the past two years written to care centres clarifying the use of different types of documentation. However, it noted some confusion and lack of understanding in some care centres."

The HSE said it would organise further training and clarification for staff.

The report, which covers 155 centres during 2016, also highlighted how lack of staff in some care centres means controls are not followed. Duties covering lodgements, payments and bank reconciliations should be split up among different health workers to avoid risk of fraud.

But the HSE insisted it was "not economically feasible for the HSE to assign extra staff to these locations".


It has put a number of controls in place to minimise risk - including reducing the total value of funds held in a care centre from €10.3m to €7.9m.

This includes paying allowances from the Department of Social Protection and pensions direction to a central unit. Local care centres are also required on a monthly basis to reconcile amounts in bank accounts.

The report said that overall "no fraud or instances of misappropriation" were identified during the year, although the internal and external reviews confirmed the breaches.

The latest report follows previous examinations of lapses in control of patients' private property funds by the HSE.

Many individual residents received a windfall from the back payments under the nursing home repayment scheme.

Commenting on the HSE weaknesses, Justin Moran, of Age Action, said: "Financial elder abuse is one of the most commonly reported forms of abuse suffered by older people."

He warned: "Those who are obliged to hand access to their bank accounts and finances over to HSE staff are in a particularly vulnerable situation and need to know that they are going to be used appropriately.

"The overwhelming majority of HSE staff are dedicated to protecting the savings of their clients.

"But we need to ensure the system is as strong as we can make it to protect people in long-term residential care."

Tadhg Daly, of Nursing Homes Ireland, representing private nursing homes that are not covered in the report, said they provide "stringent safeguards for the protection of personal property and finances of nursing home residents".

He added: "The regulations and standards are independently inspected and monitored by the Health Information and Quality Authority.

"The nursing home must ensure complete records are kept of all money and personal property that is deposited."

Irish Independent

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