Three officials from the Health Information and Quality Authority (Hiqa) were sitting around a conference room table in the healthcare watchdog’s Cork offices on September 8th, waiting to deliver bad news.
Following months of back and forth after several highly critical inspections, the regulator was taking the drastic step of shutting down a Co Waterford nursing home, run by private company Aperee Living.
Susan Cliffe, Hiqa’s deputy chief inspector of nursing homes, and two other colleagues had been due to meet David O’Shea, the sole director of Aperee, at 3.15pm that Friday.
The meeting had originally been due to start at 2.30pm, but 15 minutes beforehand Aperee had requested it be pushed back by 45 minutes.
When Mr O’Shea did not show up, Hiqa officials tried to contact him by phone without success, before he arrived at 3.25pm.
During the meeting, Ms Cliffe outlined how the Health Service Executive (HSE) would take over Aperee Living Ballygunner, Co Waterford, from October 7th, until the 46 residents living there were moved to alternative care homes.
At that point Aperee Living, a company founded by Mr O’Shea’s Cork-based investments firm the BlackBee Group, was running 10 nursing homes, caring for about 550 residents.
The nursing home group has been under serious financial strain this year, with several suppliers chasing Aperee over unpaid bills.
An Garda Síochána is also examining concerns referred to it by Hiqa over the inappropriate use of residents’ money.
Hiqa inspections found repeated instances where residents’ money was being used to cover the running costs of Aperee nursing homes, before the accounts were later topped back up.
The watchdog has been warning about conditions in Aperee’s Ballygunner nursing home for several months, documents released to The Irish Times under the Freedom of Information Act show.
In a July 11th meeting, Hiqa tabled the prospect that Aperee’s registration to run the nursing home would be cancelled.
The watchdog said it had “significant concerns” about the “fitness” of Aperee, minutes show. There had been a “failure to act in good character and engage honestly and transparently”, the State agency said.
The nursing home group had failed to put in place a proper management structure “to support the delivery of safe care to residents”, the minutes further stated.
By the middle of September the situation in the Co Waterford nursing home had reached “crisis” point.
Inspectors from the regulator had flagged serious fears about the low levels of staffing in the home, fire safety concerns as well as ongoing governance shortcomings.
Hiqa sought a meeting with Aperee on September 14th to discuss the situation. However, it was informed no one was available to attend.
In an email later that day, Ms Cliffe said it was “extremely concerning” that Aperee had not been available to discuss conditions in the Ballygunner home, which was “currently in crisis”.
In parallel discussions with the HSE, the watchdog said the majority of nurses in Ballygunner had been working there for less than 10 weeks, with some residents “very frail from a nutritional perspective”.
During a virtual meeting on September 15th Hiqa told Aperee it had decided to have the HSE take over the home “as soon as possible”, with the health service assuming control of the facility three days later.
Officials told the nursing home group conditions had deteriorated to the point where they could not leave residents “exposed” to the heightened levels of risk in the care home.
The current crisis facing Aperee has not been restricted to one nursing home. Hiqa has since moved to shut two further Aperee nursing homes, its facility in Belgooly, Co Cork, and as recently as last week its nursing home in Callan, Co Kilkenny.
Documents show Hiqa raised “significant concerns” about Aperee’s ability to run its other seven nursing homes, in a September 13th meeting.
The turmoil has also caused considerable disquiet among investors backing the nursing home group, one source said.
Neither Aperee nor Mr O’Shea responded to a series of questions about the recent correspondence and meetings with Hiqa.