All new residents of nursing homes should be tested for coronavirus prior to admission, a report by the Covid-19 Nursing Homes Expert Panel has recommended.
The report was published today and made 86 recommendations to the the Department of Health to ensure precautions against the spread of the virus are taken in nursing homes, referencing the need for "systematic reform" in the way in which care is delivered.
The expert panel of four was set up in May to examine national and international responses to the Covid-19 crisis in nursing homes, along with emerging best practice.
We do not have a vaccine for Covid-19 but we do have a vaccine for influenza.
The panel's report said that staff had worked "tirelessly and with admirable resilience" despite many being "traumatised" by their experiences, as Covid-19 outbreaks took hold in many nursing homes in the earlier months of this year.
Professor Cecily Kelleher, chair of the panel, said that nursing home deaths represented 56 per cent of all deaths in the Republic at the time of the report’s drafting.
She said preparedness for the coming months would be “crucial” as community spread of the virus rises, adding that “we do not have a vaccine for Covid-19 but we do have a vaccine for influenza”.
Key recommendations of the panel:
- All new residents of nursing homes coming from community settings, along with proposed transfers from hospitals, should be tested for Covid-19 prior to admission.
- Admissions should only be made to facilities which can demonstrate their infection control measures are of a sufficient standard to ensure there is no risk of onward infection, with HIQA maintaining a register of such homes.
- Personal protective equipment should be readily available in nursing homes around the State, with a supervisor on hand to ensure it is used appropriately.
- The influenza vaccine should be prioritised for all residents, while making it mandatory for staff should be considered.
- Nursing home staff should be precluded from working across multiple sites and adequate contracts should be in place to support this, for the next 18 months or until the declaration of the end of the global pandemic by the World Health Organisation.
- Nursing home providers should be mandated to improve education and professionalisation standards in the workforce.
- Working terms and conditions of nurses and healthcare assistants should be subject to a review in State nursing homes.
- The HSE should produce a detailed report within nine months on the management and outcomes of the multiple clusters that occurred during the pandemic.
In response to the report, Minister for Health Stephen Donnelly said that “careful consideration” would be given by the Department of Health to the panel's recommendations.
He said the impact of the pandemic had been "utterly devastating" for those who lived and worked in nursing homes, along with their loved ones: "Many residents didn’t have visitors for months. Families had to watch and try and communicate with loved ones through widows. Many people have lived in fear for months."
He said the nursing home sector remained an "absolute priority" in the Government's overall response to Covid-19, with planning preparedness and the ability to evolve in its response being key to suppressing the virus over the coming months.
He added that everything within the State's power must be done to prevent Covid-19 from taking hold in nursing homes again.
Reactions
Nursing Homes Ireland (NHI) has said the report should represent a milestone for care of the older person and its recommendations should be prioritised immediately by Government.
It comes as the report noted “feelings of powerlessness and loneliness amongst nursing homes as the State did not encompass the sector in its planning for Covid-19.”
NHI CEO Tadhg Daly said: “The expert panel finds nursing home care has been an outlier within our health services and there is requirement for enhanced and more formalised integration of it.”
The Irish Nurses and Midwives Organisation (INMO) has said it is seeking immediate dialogue with the Minister for Health on the recommendations in the report, particularly the implementation of the safe staffing framework, as it had set out on many previous occasions the risk that staff shortages could lead to higher rates of Covid-19 infection.
Too often we have seen reports like these gather dust, and this cannot be allowed to happen now. We need strong and decisive action.
The Irish Medical Organisation (IMO) has also welcomed the report, saying its recommendations are a “step in the right direction.”
Dr Denis McCauley, Chairman of the GP Committee of the IMO, said that it is “seeking urgent discussions with the Department of Health and HSE to develop a framework for medical services to patients in both public and private nursing homes.”
"The system for the provision of medical care for nursing home patients was not adequate prior to Covid-19 and was made all the more challenging by the impact of the pandemic,” he said.
“We welcome the expert panel’s acknowledgement of the vital need to recruit more GPs, address longstanding capacity issues, and empower GPs to work more effectively in the community and in nursing homes.”
“Too often we have seen reports like these gather dust, and this cannot be allowed to happen now. We need strong and decisive action in order to address these legacy issues.”
ALONE, an organisation which supports older people, has said that immediate action must be taken on the report's measures and that more needs to be done to protect vulnerable older people in residential care from coming into contact with Covid-19.
The organisation said it believes that a move towards a statutory right to home care is needed, as this would allow older people the opportunity and choice to age at home, which would in turn ease the pressure on acute medical services.
This week ALONE saw a spike in calls to its national support line from older people seeking advice on Covid-19, which the organisation believes stems directly from the recent surge of cases in the country.
