Dáil Éireann Debate, Wednesday - 31 March 2021
1066. Deputy John Brady asked the Minister for Health his plans to carry out a public inquiry into the outbreak of Covid-19 in nursing homes and the help and assistance that was provided to them during the first wave of the pandemic; and if he will make a statement on the matter. [17029/21]
View answerHIQA is the national independent regulator of nursing homes and through its powers assesses whether residential services are providing high-quality, safe and effective services and supports for the people who live there.
HIQA has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider. This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.
HIQA, in discharging its duties determines, through examination of all information available to it, including site inspections, whether a nursing home meets the regulations in order to achieve and maintain its registration status. Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes.
The Nursing Homes Expert Panel was established, on foot of a NPHET recommendation, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort. This Expert Panel report has added further to our knowledge and learning. This report clearly outlines the key protective measures that we must ensure are in place across our nursing homes. These actions are based on learning from our own and the international experience of COVID-19 to date. The report also recommends additional analysis and examination of the relevant public health and other data sets in order that further causal and protective factors for COVID-19 clusters are identified.
Work to progress the recommendations of the Expert Panel report, particularly those recommendations requiring a priority focus in the response to COVID-19, is ongoing across all of the health agencies and stakeholders. Continued learning and understanding of progression of the disease in Ireland is an integral part of those recommendations.
Residents of nursing homes are vulnerable because of their age, underlying medical conditions, the extent of their requirement for direct care involving close physical contact and the nature of living in congregated settings. The very infectious nature of COVID-19 makes it difficult to prevent and control in residential care settings. The transmission of the virus into and within nursing homes is multifactorial. As identified by the Nursing Homes Expert Panel, where there is ongoing community transmission, settings like nursing homes are more vulnerable to exposure.
The State’s responsibility to respond to the public health emergency created the need for the HSE to set up a structured support system in line with NPHET recommendations. This has been a critical intervention in supporting the resilience of the sector in meeting the unprecedented challenges associated with COVID-19. The supports provided during the first wave included:
- Enhanced HSE engagement.
- Temporary HSE governance arrangements.
- Multidisciplinary clinical supports at CHO level through 23 COVID-19 Response Teams.
- Access to supply lines for PPE, medical oxygen etc.; significant volumes of PPE was supplied to private and voluntary nursing homes on a without charge basis.
- Serial testing in nursing homes.
- Access to staff from community and acute hospitals.
- Suite of focused guidance.
- Temporary financial support scheme established, with over €80.1m in additional funding support provided thus far at 26 March. The Scheme is open until 30 June 2021.
- Temporary accommodation to nursing home staff.
- HIQA Infection Prevention Hub.
- Regulatory Assessment Framework of the preparedness of designated centres for older people for a COVID-19 outbreak designed by HIQA.
