HSE's most expensive nursing homes failing key standards tests
Inspectors uncover issues with fire safety and residents' rights
Some of Ireland's costliest public nursing homes are failing to meet key standards in looking after older residents.
The most expensive, St Finbarr's Hospital for older people in Cork, costs €2,182 a week per resident yet failed to comply with 14 of 17 regulations demanded by the health watchdog Hiqa.
Despite fees equating to €311 a night, the hospital failed in areas such as residents' rights, fire safety, governance and end of life care, according to the latest inspection report.
St Finbarr's is one of six nursing homes run by the HSE where a bed costs more than €2,000 a week, twice as much as many private nursing homes. Cherry Orchard, in Dublin, where fees are €2,040, did not comply with five regulations, two of which related to some abuse allegations being inappropriately recorded as "complaints". Many residents spent a "considerable period of time" in bed or sitting at their bedside, which inspectors blamed on institutional practices at the centre.
Edenderry Community Hospital in Offaly, where a bed costs €2,082 a week, failed five of 17 regulations, in staffing, training, governance, managing challenging behaviour and residents' rights. In one part of the home, doors were electronically locked and residents had to ask for them to be opened to access the gardens, oratory or dining room.
St Patrick's Community Hospital in Co Leitrim, which charges €2,152 per week, passed all but two standards - storage for residents' belongings and the premises itself.
The scale of fees paid to public or HSE-run nursing homes has been a long-standing source of contention with private and voluntary operators. A report by the Public Accounts Committee found that more than two-thirds of the €1bn Fair Deal budget was spent on HSE-run nursing homes. Private and voluntary nursing home fees are set by the National Treatment Purchase Fund and are on average 60pc lower than those at HSE-run nursing homes.
The HSE acknowledged the higher costs of care in its nursing homes. It said St Finbarr's Hospital is a long-stay care facility for people with high-level needs. The HSE said non-compliance with regulations in older care centres in many cases related to "environmental challenges". Issues at St Finbarr's Hospital, St Patrick's Hospital and Cherry Orchard are being addressed in the Capital plan.
St Brigid's, in Shaen, Portlaoise, which costs €2,336 per week, and Abbeyleix District Hospital, where the fees are €2,298, were largely compliant with regulations. Hiqa inspectors called for fresh safeguarding training for staff and more activities for residents at St Brigid's, while Abbeyleix fell down on the failure to hold fire drills at night.
The HSE said St Brigid's high fees resulted from supporting people with high-level needs, while the number of beds at Abbeyleix was being reduced, which had impacted on the cost figures.
Nursing Homes Ireland accused the HSE of understating the real cost of a bed in a public nursing home as its rates don't include the value of the capital costs and the additional unseen services that come with being run by the HSE. The Department of Health is reviewing the fees charged by public nursing homes.