Health authorities in Dublin last night confirmed that a small group of patients died last year after their transfer from St Ita's psychiatric hospital to Leas Cross nursing home.
Sources said that four or five of the 20 patients transferred from St Ita's last year died at Leas Cross.
However, it is understood that health authorities do not consider there was an unusually high mortality rate among this group of patients. Sources said that the patients involved were very frail and elderly.
Fine Gael leader Enda Kenny told the Dáil yesterday that an unusually high mortality rate at Leas Cross was highlighted in a report drawn up by the former head of the Blood Service, Martin Hynes. The Taoiseach confirmed that the draft Hynes report had been received last autumn. It will be published at the end of the month.
The Irish Times understands that the Hynes report advised health authorities last year that they should establish a high-level inspection team to examine the controversial Leas Cross nursing home. This team would be separate to the group that had visited the facility previously.
The Hynes report is not explicitly critical of the way health authorities inspected Leas Cross. However, sources said that it contained a series of basic recommendations on what inspectors should look for, including examinations of the quality of care provided, the freedom of choice available to patients, the adequacy of clothing and the level of privacy.
The Irish Times revealed yesterday that the Hynes report will criticise the standard of care provided to a 60-year-old man with Down's syndrome and Alzheimer's disease who died two weeks after being admitted to the nursing home.
Meanwhile it has emerged that health board inspectors raised serious questions about hygiene and medical standards at Leas Cross from 1999. The documents were obtained by Fine Gael TD Fergus O'Dowd.
Following an inspection on February 16th, 1999, the health board was told that the "overall hygienic condition" of the home was not adequate.
Warning of "concerns" about kitchen hygiene, the inspector, wrote: "Uncooked meat stored on top shelf in fridge with fruit salad and dessert."
Replying to a question about whether the standards governing the preparation of food were adequate, the inspector wrote, "No." Speaking in the Dáil on June 1st, Taoiseach Bertie Ahern said health board offices "had problems, complaints and issues with the management and staff of Leas Cross" - though he did not make it clear, or he did not know, that the problems extended back six years.
The report also recommended towel rails in all shared rooms. It pointed to concerns about food handling and storage practices in the kitchen and urged improvements in the drug recording system.
On July 9th, 1999, hygiene standards were again described as inadequate by the same inspector. The inspector also found that "the drug recording system was unsatisfactory" for practically all residents.
On February 15th, 2000, a more positive report was recorded, which found hygiene and kitchen standards satisfactory.
However, inspectors again pushed nursing home staff to put in place rules to govern "drug administration, physical and chemical restraints". They also urged that two nurses should be on duty in the home.
In a briefing note for patients' families yesterday, the Health Service Executive (HSE) said it had proposed changes at Leas Cross following an April inspection.
"In the meantime, the RTÉ Prime Time programme escalated the HSE concerns in relation to the level of patient care," it said.
Last night, Mr O'Dowd said the fact that the documents dated back to 1999 meant that "the HSE's statements that they are shocked and appalled were nonsense. They knew that there was a lot going wrong with it, to take the most benign view possible."
Questioned about the inspectors' reports yesterday, the owner of the nursing home, John Aherne, said Leas Cross had never refused to carry out recommendations.
"Why didn't they follow it up if they had a problem?" he asked. He has said he would fight any move to close the facility.
