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Half of nursing homes did not have proper infection controls - watchdog

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A stark insight into poor infection control in many Covid-hit nursing homes, where the bedroom doors of infected residents were left open and staff suggested a "neighbour might do the laundry", has been revealed in a new report.

Half of all people who have died from the virus here so far were residents of nursing homes and the report - based on inspections by watchdog the Health Information and Quality Authority (Hiqa) - shows how many homes were ill-equipped to deal with the threat from the deadly infection.

In one case, chief inspector Mary Dunnion was so concerned about the ability of an unidentified nursing home which was struggling with an outbreak to care for 16 residents that an emergency court order was sought to close it down on May 30.

The report shows that of the 44 homes inspected since May most failed to fully meet regulations and six in 10 were in breach of governance and management standards which are key to the proper running of a facility.

The findings revealed:

  • Half of nursing homes visited had inadequate infection prevention and control measures in place;
  • In one case the bedroom door of a resident positive for the infection was open;
  • Staff were observed caring for residents in close proximity without using surgical masks;
  • In other homes temperature checks on staff were not logged;
  • Some homes had outdated layouts where residents shared bedrooms and bathrooms;
  • Nursing homes were hit by staff shortages. In more than one in five of the homes there was a lack of staff, with several out sick with the virus.

Covid-19 has brought into sharp focus the need for reform of current models of care for older people here.

Ms Dunnion said: "The continued use of multi-occupancy rooms and outmoded premises in some nursing homes undoubtedly created challenges in containing the spread of infection.

"We must look to complementary models of care, such as homecare and assisted living, and ensure that there is improved clinical oversight in all nursing homes.

"Furthermore, the regulations governing nursing homes are outdated and must be revised to make them fit for purpose, particularly as regards governance, staffing numbers, skill-mix and infection prevention and control."

The impact on residents and staff is also highlighted in the report, particularly the sadness felt by residents due to visitor restrictions.

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They spoke of a deep sense of isolation and loneliness at not being allowed to see their families.

The residents experienced a range of emotions.

"Some feared contracting the virus and worried about their family and friends, while others felt a deep sense of isolation and loneliness as a result of the visiting restrictions," said the report.

"Without exception, residents were deeply grateful to staff in nursing homes for the care they provided in extremely challenging circumstances."

In response, Tadhg Daly, chief executive of Nursing Homes Ireland, which represents private nursing homes, said: "Hiqa states residents were 'enthusiastic' in their praise of staff, despite the long hours and stress."

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