Kerry nursing home staff ‘visibly upset’ over health of residents as Covid raged in facility

The impact of a Covid-19 outbreak in the Oaklands Nursing Home in November of 2020 that resulted in the deaths of nine residents positive with the disease was ‘magnified by a failed system of governance and management’ according to inspectors with the Health Information and Quality Authority (HIQA).

HIQA officials witnessed what they described as a ‘centre in crisis’ on an unannounced inspection of the Covid-struck facility on November 4 of 2020 – what had been the sixth inspection of the nursing home in the space of the previous 12 months.

Details of the damning report were finally revealed this week after a copy of the inspection results was obtained by Louth Fine Gael TD Fergus O’Dowd on a foot of a Freedom of Information (FOI) request.

HIQA would ultimately obtain a court order later in the month allowing the HSE take over the running of the facility on foot of serious infection control concerns and amid evidence of chaotic scenes within the centre; including residents continuing to mix with one another despite being positive for Covid.

But the November 4 inspection report, which had not been published by HIQA as the home had ceased operating –in December of 2020 – reveals the alarming situation within Oaklands to a clearer degree.

Deputy O’Dowd said the ‘shocking’ contents of the report support growing calls to include nursing homes within the terms of reference of the planned public inquiry into the State’s handling of the pandemic.

27 of the 32 residents present in the facility at the time of the November 4 inspection had already tested positive for Covid. 18 were then symptomatic.

But inspectors had difficulty locating and talking with the nurse who was in charge of the centre on November 4, amid serious concerns over the level of staffing on the day.

“Present in the centre at that time were three regular care staff and two cleaning staff who were visibly upset about how unwell the residents were,” the report states.

“A number of staff told the inspectors of their concerns over the last week about residents who appeared to be unwell or off their normal baseline.”

They reported their concerns to nursing staff and the person in charge...”and were informed that residents had urinary tract infections and it had been inferred that it was because the staff were not ensuring adequate fluids were given,

“Care staff said they were very upset about this and felt they were not being listened to,” the report stated.

Care staff also reported that while some residents were prescribed antibiotics or paracetamol for a temperature, no action was taken to isolate and test the resident for Covid-19.

Records obtained at the time of the visit provided evidence of a ‘failure to recognise Covid-19 symptoms in residents dating back to October 27, 2020.

Inspectors found a facility not prepared for an outbreak of Covid-19 ‘as there was no identified isolation area, and no area designated as a clean area.’

Staff were not changing PPE between residents; cleaning staff were informed by a manager there was no need to deep-clean a room vacated on the transfer of the Covid-19 resident to hospital. “A number of residents were seen to wander around the centre...inspectors saw that staffing levels did not facilitate the ongoing supervision of these residents.” Indeed, HIQA found there was ‘inadequate staff’ to care for the intensive needs of the residents at the time.

HIQA observed poor communication with residents including one instance in which the HIQA inspector had to ask for a resident to be informed of their test results. Many families were still in the dark over their loved ones’ Covid status, frantically ringing to no avail as the media was reporting of the Covid outbreak.

The HSE agreed with the provider , Bolden Nursing Ltd, to take over the clinical management of the centre at 4pm on the day – with the HSE team then observed to have been ‘instrumental in giving stability, managerial and decision making capacity to the centre that was not evident prior to their taking over the clinical management.