New oversight system for care homes to include religious orders

The Government is to change the system of oversight of all long-term care homes to include religious orders and other residents of congregated settings not previously registered with the Health Information and Quality Authority (Hiqa).

Minister of State for Health Mary Butler announced her plan to make changes after a number of religious orders and other private or voluntary care homes were not included in the initial vaccination of residents and carers in Hiqa-registered nursing homes.

Ms Butler confirmed in the Seanad that vaccination began on Monday of those over 65 in non-registered long-term care settings, including homes where people have their own front door but live in congregated settings. She said inoculation is expected to be completed by the end of February with the second vaccination four weeks later.

The Minister met Department of Health officials this week to discuss non-registered homes “because I do believe we have to have oversight going forward of all people who are living in residential settings. Whether they are carer-led, nurse-led whether religious, it makes no difference.

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“And even from a safeguarding point of view it’s very, very important that we know where our older people are living and who’s caring for them.”

Some 56 per cent of all deaths - 1,739 residents - have died either with Covid or because of Covid, she said. The Government hopes to receive 250,000 vaccines a week from April onwards “while this week we only received 21,600”.

Catch-up

The Minister was responding to Independent Senator Rónán Mullen who said the HSE was “behind the curve” and playing catch-up with vaccination in non-registered homes.

Mr Mullen said that early last summer when concern was raised about the need for Covid-19 support for non-Hiqa settings, the HSE provided specialist advice, PPE supplies, oxygen, extra staff and Covid response teams were provided.

He was concerned that despite this it emerged in recent days that “the HSE didn’t know how many retired clergy were living in congregated settings and the chief operations officer said they had no line of sight outside what was registered with Hiqa” and they were making a list of them now.

“The HSE was on hand during the summer and gave great support and yet the information wasn’t collated for the vaccines” and “that’s why now we’re all playing catch-up”.

Ms Butler said some religious orders are registered with Hiqa but others are not and “that’s a decision they took themselves” in 1992 when nursing homes were first regulated.

She said she had the list now of all non-registered settings and she intended when they had all been vaccinated to write to the all the orders about this issue.

The Minister also told Fianna Fáil Senator Pat Casey that a review of the priority list for vaccination would be completed "quite quickly" after he appealed for those on dialysis or who had received kidney transplants to be moved up the cohort list to the same level as those in nursing homes.

Mr Casey said there is a 25 per cent mortality rate among renal patients who become infected by Covid-19. The international evidence is there “that those on dialysis or who have received kidney transplant should be moved up to be in the same group as nursing home residents”.

Ms Butler said they are in group 5 and group 7 but she said that “people with chronic kidney disease are not a homogenous group and may be included under priority groups one and two”.