The HSE’s early response to nursing homes battling large Covid-19 outbreaks at the peak of the pandemic in April was “reactive and piecemeal”, a senior inspector at the State’s health watchdog said.

Internal correspondence between Health Information and Quality Authority (Hiqa) officials, who inspect and regulate care facilities, raised concerns about the HSE’s initial response to the Covid-19 crisis at the time.

Mary Dunnion, chief inspector of social services, highlighted the deteriorating situation in one nursing home in an April 3rd email to Hiqa chief executive Phelim Quinn.

Hospital Report

Ms Dunnion said while the HSE had assisted the home, the support had been “reactive and piecemeal and has not been informed by a strategic recognition of the deteriorating situation”.

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The home would have “benefited from a more strategic co-ordinated approach” from the HSE on issues such as supply of personal protective equipment (PPE), testing for staff and residents, and infection control advice, she said.

The healthcare system was struggling to deal with the divide between State-run homes and private operators, she said. About 80 per cent of the homes in the State are run by private or voluntary providers.

Outbreak

The criticism emerges as a Co Laois nursing home confirmed on Tuesday that it was dealing with 31 Covid-19 cases in one of the biggest virus outbreaks in a care facility since coronavirus infections started rising again during the summer.

The privately run Kilminchy Lodge Nursing Home in Portlaoise said it was managing 21 cases of the Covid-19 disease among residents and a further 10 cases among staff.

The State's chief medical officer, Dr Tony Holohan, warned about increasing Covid-19 cases in nursing homes in a letter on Sunday seeking stronger public measures to suppress the virus.

He said that at least 45 further coronavirus cases had been confirmed among nursing home residents in seven new outbreaks reported over the past week with 31 outbreaks still open.

The issues highlighted by Hiqa in the internal April correspondence, released under the Freedom of Information Act, forecast problems that later exacerbated large outbreaks in many nursing homes and led to significant numbers of deaths among residents in April and May.

Ms Dunnion told Hiqa chief Phelim Quinn that care homes required a “consistent supply” of PPE and prioritised staff testing, and that “staff unnecessarily off work” was adding pressure.

In another email, Dr Conor Teljeur, Hiqa's chief scientist, raised concerns internally that "at least one" nursing home may have been under-reporting Covid-19 cases "quite substantially".

The home later clarified that it had been under pressure dealing with an outbreak that caused an administrative backlog notifying Hiqa of Covid-19 deaths.

In a statement, the HSE said it had supported private nursing homes experiencing outbreaks with both PPE and specialist consultants on-site.

“The provision of PPE was also prioritised for sites that experienced outbreaks. This was the case even prior to the State securing a consistent supply of PPE in a very challenging international market,” it said.

“The utilisation of Covid-19 testing at that time was assigned based on availability as per nationally issued protocols,” it said.