Watchdog's inspectors have not yet visited nursing homes with coronavirus outbreaks
Nursing homes resorted to using painters’ overalls and masks made by dressmakers as they battled Covid-19, newly released documents reveal.
Testing for the virus, which took up to 20 days in some cases, and the impact of losing staff because of an HSE recruitment drive also added to pressures felt in the sector.
The shocking revelations are contained in correspondence between Department of Health and Nursing Homes Ireland (NHI), who represent the private and voluntary nursing home sector.
Communication between the Department and NHI, which runs to hundreds of pages, began in January, when NHI first sought assistance for the sector in dealing with the predicted surge in nursing homes.
As the crisis deepened in April, Nursing Homes Ireland conducted a survey of its members which was forwarded to Mr Harris. Some 44 per cent of nursing homes said they were waiting more than 10 days for testing.
One operator reported that one resident had died while waiting on a test result while another said, “still waiting 20 days later”.
Further comments about testing stated: “taking so long that it is redundant”
In relation to PPE, 88pc of nursing homes surveyed said they had to source supplies privately and 8pc said they had been forced to “utilise some home-made supplies.”
One operator noted: “We have received eye protection from a local school, overalls from a local vet and facemasks purchased from a dressmaker."
Another nursing home said they were using “painters overalls, painters goggles, surgical masks that cost €1.50 each”.
“We have spent over €12,000 and have more orders coming,” it said.
Another operator said:” I have been waiting for PPE for 18 days and we have been assured we will be prioritised five times. Promised delivery yesterday as it had been dispatched, still waiting.”
In relation to staffing levels, members reported losing nurses, healthcare assistants and senior staff members “to the HSE,” who were recruiting for acute hospital staff at the time.
Meanwhile, the State's health watchdog has not yet inspected any nursing homes where there has been a Covid-19 outbreak.
While the Health Information and Quality Authority (Hiqa) has carried out 200 inspections of facilities since March 1, none of them have been places where there has been cases of coronavirus.
The situation has been described as "disappointing" and "concerning" by Labour TD Duncan Smith.
Nursing homes have had some of the worst outbreaks of coronavirus during the pandemic.
Hiqa's chief inspector of social services Mary Dunnion told a Dáil probe of the State's response to the pandemic that inspectors are due at Dealgan House in Co Louth - one of the worst-hit care homes - tomorrow.
Mr Smith asked Hiqa officials if any inspectors have physically gone to nursing homes where there have been major outbreaks.
Hiqa chief executive Phelim Quinn said the pattern of inspections has been informed by what is being done in other jurisdictions in Europe and the UK.
He said Hiqa reserved the right to do what it calls "risk-based inspection" throughout the pandemic.
Ms Dunnion said: "To date, we have not gone where there has been a Covid outbreak.
"However, that situation is now changing because we are moving now into risk-based inspections now under the guidelines of the national public health guidance."
She said the inspections that have happened since March have been related to new centres opening or homes increasing capacity.
Ms Dunnion said other inspections have been related to contingency planning in nursing homes that have not had outbreaks to identify risks.
She said this has been a good exercise and that risk-based inspections are beginning now.
Ms Dunnion also told TDs that Hiqa sent a list of high risk nursing homes to the Department of Health and the HSE in "February/March".
It came after Social Democrats co-leader Róisín Shortall asked when Hiqa had raised concerns with about nursing homes that previously fared poorly in annual inspections.
Ms Dunnion said that at the start of the pandemic Hiqa "identified premises that would challenge and be challenged to manage a Covid outbreak.
"They would have been communicated with the Department of Health and the HSE."
She said Hiqa determined that "single, stand-alone providers" and "limited companies" and those that had previous regulatory non-compliance on infection control, governance, risk management and staff training were considered at risk.
Ms Shortall asked if Hiqa had gotten a response to the list.
Ms Dunnion said the Department of Health sent "just an acknowledgement".
Separately, a claim that the nursing homes were left "isolated" by the State in the early days of the coronavirus outbreak has been angrily rejected in the Dáil.
Fine Gael TD Fergus O'Dowd insisted that the allegation by Nursing Homes Ireland boss Tadhg Daly is "patently and obviously untrue".
It comes as the Dáil's Special Committee on Covid-19 Response probes the situation in nursing homes - one of the parts of the community worst-hit by the pandemic.
Mr Daly claimed “key State organisations left the nursing home sector and its residents isolated” in the early days of the crisis.
He added: “The dismay will live forever with us” while also saying he welcomed the supports provided by public health authorities as the crisis continued.
Mr O'Dowd referred to the details of correspondence and meetings between NHI and the Department of Health which have been published today.
He said that in one on March 17 NHI thanked the Department for "regular and ongoing communications" and another communication the following day where NHI thanked officials for its continued collaboration.
He pointed to an item of correspondence on March 24 where NHI was looking for financial assistance and said the government's temporary financial assistance scheme was launched days later.
Mr O'Dowd argued that the communications makes Mr Daly's claim that the sector was isolated is "patently and obviously untrue".
He pointed out that NHI has 12 directors and some are "very wealthy". He said that there was €23.3m in profits for eight of those directors in the last account year.
Mr O'Dowd put it to Mr Daly that the nursing home sector has "a lot of money" for buying things like Personal Protective Equipment (PPE), for testing and for paying for extra staff during the crisis.
Mr Daly insisted the sector "takes its responsibility seriously".
He said PPE was unavailable to the sector from the normal suppliers and that testing was being done nationally by the HSE.
Mr Daly insisted that nursing homes spent "millions" in extra expenditure on PPE and more staff.
He said that €8.7m has been drawn down from the government's temporary financial assistance scheme.
Mr O'Dowd said: "That's government money being refunded to you".
Mr Dowd repeated that Mr Daly's claim that nursing homes were isolated is "not a fact".
He also hit out at how just 123 nursing homes out of 581 were fully compliant with standards in the most recent Health Information and Quality Authority (Hiqa) report from 2018.
Mr O'Dowd said there were failures in risk management in 22pc of homes and in infection control in 18pc.
Mr Daly said the Hiqa findings were for all nursing homes, public, private and voluntary and that the agency highlighted high compliance rates.
Mr O'Dowd said the report also shows that compliance rates had gone down from 27pc in 2017 to 23pc in 2018.
The Fine Gael TD said that care of older people in nursing homes is "not acceptable".
He claimed: "the nursing home private sector is not complying... they are very wealthy companies who complain that the taxpayer isn't doing enough for them"
He said there needs to be "a total change in the way the care of older people is looked at."
He said no one had died from coronavirus in nursing homes in Hong Kong and added: "I just get so angry at this."
Mr Daly said nursing homes are the most highly regulated part of the health service and Hiqa can close nursing homes where standards are not acceptable.
He said a whole suite of care services for the older population needs to be developed and added: "we won't be found wanting in terms of our responsibility at all."