The Health Service Executive (HSE) declined a request to continue to manage a Co Kerry nursing home during a serious Covid-19 outbreak, despite pleas from the home's general manager that the "crisis" situation was worsening, emails show.
The HSE maintained it had "stabilised the situation" in Oaklands Nursing Home, and on November 18th declined an appeal to continue to oversee the clinical management of the facility.
The next day the Health Information and Quality Authority (Hiqa) sought a court order to direct the HSE to take over the facility, due to a risk to life for residents amid serious infection control failings.
The 51-bed nursing home in Listowel had been run by a private provider, Bolden (Nursing) Ltd.
Correspondence between the HSE, Hiqa, and the nursing home were released to The Irish Times under the Freedom of Information act.
The HSE initially took over the clinical operation on November 4th, as the nursing home was in “chaos” during a serious Covid-19 outbreak, after 30 residents and nine staff tested positive.
In a November 4th email, the HSE said “this will be for a minimum of two weeks and we anticipate up to a four week period or until such time as the staffing and management structure can be stabilised.”
However, one week later, Michael Fitzgerald, chief officer of HSE Cork-Kerry Community Health Care, told Hiqa the management of the home would be handed back to the private provider on November 16th.
In a November 13th email, the general manager of the nursing home wrote to Mr Fitzgerald requesting the HSE continue managing the facility for the originally planned four-week period.
In response, Mr Fitzgerald said “it is the view of the HSE, that as the provider of the service you have sufficient nurse management capacity available.”
“We are also satisfied that the residents have been clinically managed to a stable position,” he said.
On November 17th, after resuming management of the home, the general manager emailed the HSE outlining serious staff shortages.
“I am still struggling with staffing as regards nursing staff. I have only three out of nine nurses available to work,” she said.
In response the HSE said it was trying to pull staff from other healthcare services to help, but that this was proving “very challenging”.
The general manager said the situation had “worsened” and she was in “crisis mode”. She asked the HSE as a matter of “extreme urgency” to deploy a clinical lead nursing professional to Oaklands.
In a November 18th letter, Mr Fitzgerald told the nursing home “it is not the intention of the HSE to resume a role as clinical lead and we have to decline your invitation.”
“It is not the case that the HSE are willing to remain in a centre indefinitely and its expectation is that the provider maintains or resumes its full responsibility, including staffing and oversight, at the earliest date possible,” he said.
The next day Hiqa sought a court order to cancel the nursing home’s registration over safety concerns, and to direct the HSE to assume responsibility for the residents.
The HSE closed the facility earlier this month with the remaining residents transferred elsewhere.
A HSE spokeswoman said it had provided “a high level of support” to Oaklands in late October and November. It took over clinical management for the “shortest time possible,” and afterwards continued to provide support and supply staff.
“We understand that Hiqa was still not satisfied with a range of issues relating to the provider, including governance arrangements and had such concerns that led them to decide to seek the court order to withdraw registration,” she said.
