'Substandard care at Leas Cross'

Standards of care at the controversial Leas Cross nursing home in north Dublin fell below acceptable levels for a period of nearly two years, according to a new report.

The report criticises the role of the health authorities in dealing with issues at Leas Cross. However, it says it did not find evidence of a "sustained pattern" of inadequate care at the home.

According to the report of the Commission of Inquiry into care at the home, the decline in standards of care coincided with a significant increase in the number of frail, highly dependent residents admitted to the home between September 2003 and January 2004.

Many of these new residents came from nearby St Ita's Psychiatric Hospital and from other general hospitals, according to the report.

It says the evidence suggests that for a two-year period, standards of care at Leas Cross fell below acceptable levels.

The report said the evidence indicated that that the principal cause of the decline in care standards between 2003 and 2005 was the failure of Leas Cross to employ a sufficient number of competent staff to provide the necessary standard of nursing care.

The Commission, under barrister Diarmuid O'Donovan, found that the registration of 73 additional beds at Leas Cross was granted by the then Northern Area Health Board (NAHB) without adequate regard to the well-being of the residents.

The report said the health authority failed to give detailed consideration to the viability of a nursing home for 111 residents and the likely ability of the nursing home's management to cope with the increase in residents.

The Commission found that as a result of evidence from inspections, the NAHB and later the HSE had detailed information about the nursing home, which included evidence of recurring problems.

The report says this information should have alerted the health authorities to impending problems which could have been avoided.

It adds that the relevant information on Leas Cross was divided between a number of locations and therefore no single office or individual has full knowledge of all available information.

"The HSE cannot rely on its administrative arrangements to excuse this failing," the report says.

The report also expresses concern about the adequacy of the inspection process.

"In particular, it highlights the inability of the inspection system to identify deficiencies in nursing home care without adequate time and resources."

Health Minister Mary Harney, launching the report, said its recommendations were a solid basis to bring improved quality service provision in the future.

She pointed out that a new independent inspection regime had now been established for nursing homes under the aegis of HIQA.

This would be an "effective, robust, independent and properly resourced" inspection regime, the Minister said.

Concerns over care at Leas Cross were first raised in an RTE Prime Time programme. The home closed in August 2005.

This is the second recent review of care at Leas Cross.  The 2006 O'Neill review concluded that care in the nursing home between 2002 and 2005 amounted to "institutional abuse".

Prof Des O'Neill's initial review had looked into the deaths of 105 elderly patients resident in Leas Cross over a three-year period.

Minister Harney set up the subsequent Commission review in April 2007.

[Posted: Thu 16/07/2009]