Nursing Home Scandal Coming Again

zerosugarbuzz

zerosugarbuzz wrote: »

We need to look at and radically change the way we "look after" our old folk going forward. My parents and those of most of my friends were looked after by family in their old age. When exactly did working and earning money become more important than family.

Not everyone is mentally and emotionally equipped or qualified to look after an elderly person 24 hours a day. Especially if there is a condition like alzheimers or dementia involved.

Don't shame families for this.

wheresthebeef

[Deleted User] wrote: »

Not everyone is mentally and emotionally equipped or qualified to look after an elderly person 24 hours a day. Especially if there is a condition like alzheimers or dementia involved.

Don't shame families for this.

Not to mention that as people now live longer, they are living with much more complex needs like increased physical frailty or dementia.
Families care for people for as long as they possibly can, and sometimes for longer than they should before they eventually accept they they cannot do so safely anymore.
There’s huge guilt attached to making the decision that someone needs care and it’s not a decision that anyone takes lightly.

Geuze

Feria40 wrote: »

This is a TINY nursing home. At this level with less than 30 residents, the owner is likely able to achieve nothing more than the average industrial wage for him/herself each year. At best.

Quick calculations

31 beds * 800 * 52 weeks = 1.29m revenue.

Allow for voids, say 1.1m

There are 17 staff

https://www.rte.ie/news/coronavirus/2020/1022/1173211-nursing-home-coronavirus/

Bear in mind this is a rural village.

8 nurses * 50k = 400k

11 care assistants * 35k = 385k

785k labour

Still 315k left, so mplenty of room for profit...............

JustAThought

Geuze wrote: »

Quick calculations

31 beds * 800 * 52 weeks = 1.29m revenue.

Allow for voids, say 1.1m

There are 17 staff

https://www.rte.ie/news/coronavirus/2020/1022/1173211-nursing-home-coronavirus/

Bear in mind this is a rural village.

8 nurses * 50k = 400k

11 care assistants * 35k = 385k

785k labour

Still 315k left, so mplenty of room for profit...............

Your simplistic list left out some other basics: Food, physio, doctor on call, heat for a building 24/7 holding 30 frail elderly patients, administrative staff, recepetion staff, cleaning staff, overhead costs like light, broadband, not to mention accountants, end of year audit fees, HR, payroll, and of course the whopping great mortgage on the place and H&S compliance costs on the place as well as corporation tax on the square footage of the place, business rates, commercial water rates, and the employer tax on each staff member and business taxes - and thats before there is building fire insurance, business insurance, claims insurance, personal indemnity insurance, training costs for staff, upkeep and maintenance of the property or grounds or a single slice of paper or bic biro bought for the place - let alone specialised baths, hoisting equipment etc - oh - nor a penny paid to any of the directors, shareholders or owners.

That a recent HIqUA report was done and showed so much compliance is no doubt a huge relief to them. What most people don’t know is that HIQUA are NOT obliged after the set up to even do one annual report on every nursing home in Ireland - maybe that is the other disgrace and national scandal hidden in plain sight that we should highlight from this.

JP Liz V1

average_runner wrote: »

Down home where one of my parents are in a nursing home, the staff are tested every week. Its a private nursing home.
Did the staff not show any symptoms? What protocols were broken for this to happen?

I thought testing was constant in these homes, regular even more so now

I feel for anyone with relatives or friends in a home

Dempo1

wheresthebeef wrote: »

This is a small family run nursing home. It’s most recent HIQA report was very detailed and demonstrated full compliance across all the standards including Infection Control. By all accounts a well run home with responsible owners.

The reason this happened so quickly is due to a number of reasons. Firstly, I’d guess with a home this small, there is no subdivisions within it so probably just one dining room, one or two day rooms, one staff room.
Staff in nursing homes are only tested once every 14 days. Nursing homes have asked for it to return to weekly testing which would catch cases sooner but the HSE don’t have capacity.
All staff are tested on one day and results come in over a period of 6-8 hours. A single positive amongst staff will trigger a blanket test of all residents.
Covid-19 can transmit and present asymptomatically even in older people. Due to high levels of community transmission, it is likely that a single staff member came to work, somewhere in the gap between testing days and seeded an outbreak which then moved through the home silently infecting people over a number of days.
On the next staff testing day, almost all the staff tested positive resulting in their exclusion from work and then the residents were tested and found to be similarly badly affected.
No contingency plan in the world could counteract a situation like this. Nursing homes have added extra staff to ensure adequate care if a number of staff need to be absent, but there’s no way you could employ a double set of staff for every home and keep a whole team in reserve.
People talking about nursing homes getting paid €1000 a week per resident have no clue how much it costs to run a home. That’s just over €5.90 an hour per resident. You wouldn’t get a babysitter for that money. 70% of income goes straight back into the hands of staff with all other overheads, costs and bank debts/interest etc... left to be covered from the remaining 30%. The huge nursing homes owned by international investment firms can make decent profits because of economy of scale where you have 120 beds or more.
The 28 people who live here are human beings who deserve to be cared for properly which this nursing home was doing as evidenced by their HIQA reports until their staff had to leave. The state has chosen to subcontract their care to someone else, but remains ultimately responsible.
There may be lessons to be learned but the outcry at this time should be for those poor older people lying scared in their beds wondering who will help them.

Rapid point of care testing could change this situation meaning you could catch cases far quicker before they have a chance to spread. Testing people only every 14 days is effectively useless.

I agree that this nursing home has an excellent reputation (albeit I was a little concerned at the appearance of the place on the news yesterday, cracks in plaster, hole in one wall, exterior wall and landscaping pretty grubby to be honest), this said, the issue is the apparent lack of support that was forthcoming from the HSE when the home contacted them. A staff member having to contact a local GP in absolute desperation does not inspire confidence and the HSE"s acting chief opperstions officers appearance on the evening news bulletin was less than inspiring.

Bannasidhe

As far as I am concerned I don't give a flying if a nursing home is private or public, or tbh at this point discussion how the virus got in there. That can be investigated once the residents have proper care.
Right now the only concern is that the virus is in there.
They do not have adequate staffing to care for residents.

They need help now.

Govt and the HSE need to step up and make sure they immediately get that help.
It shouldn't take GPs taking to twitter, newspaper articles, Liveline.
It should be as simple as an dedicated emergency line and if necessary the Army Medical Core provides temporary cover until the situation can be stabilised.

VillageIdiot71

Bannasidhe wrote: »

... if necessary the Army Medical Core provides temporary cover until the situation can be stabilised.

Do we have a particularly large Army Medical Corps, with the capacity to manage the running of a nursing home?

Look, whatever we make of individual events, can anyone doubt the willingness of the Government to incur incredible costs in pursuit of whatever ill-defined goal we're collectively meant to be pursuing in respect of this virus?

Or do we just lurch from one expression of righteous indignation to another, without ever asking what's a reasonable expectation?

ohnonotgmail

VillageIdiot71 wrote: »

Do we have a particularly large Army Medical Corps, with the capacity to manage the running of a nursing home?

Look, whatever we make of individual events, can anyone doubt the willingness of the Government to incur incredible costs in pursuit of whatever ill-defined goal we're collectively meant to be pursuing in respect of this virus?

Or do we just lurch from one expression of righteous indignation to another, without ever asking what's a reasonable expectation?

it is a reasonable expectation for the HSE to provide staff to help run the home in this situation. The Minister said they would put contingencies in place for such a situation. They haven't.

plodder

Seems strange that the staff are only getting tested every two weeks. Even a single batch test of all the staff every few days would be better than that.

bureau2009

One would hope that the State has the resources, willingness and cop-on to provide every practical support to this nursing home immediately.

But I doubt this will happen.

And all I'm hearing in response is carefully crafted PR speak.

VillageIdiot71

ohnonotgmail wrote: »

it is a reasonable expectation for the HSE to provide staff to help run the home in this situation. The Minister said they would put contingencies in place for such a situation. They haven't.

And I'm not particularly defending that.

Just linking to the willingness of Government to close down huge parts of the economy, at great human and financial cost. So, indeed, no problem putting half a million people out of work on the stroke of a pen.

Put another way, its not a resourcing issue. Its a simple unwillingness by HSE staff, such as nurses getting full pay in services that aren't really functional at the moment, to transfer into nursing homes where they might actually have a job to do.

You'll wait, I suspect, before you'll see the issue pitched like that. Easier to blame it all on Stephen Donnelly, as he comes across as a bit gormless.

Bannasidhe

VillageIdiot71 wrote: »

Do we have a particularly large Army Medical Corps, with the capacity to manage the running of a nursing home?

Look, whatever we make of individual events, can anyone doubt the willingness of the Government to incur incredible costs in pursuit of whatever ill-defined goal we're collectively meant to be pursuing in respect of this virus?

Or do we just lurch from one expression of righteous indignation to another, without ever asking what's a reasonable expectation?

They don't need to 'run' it.
They can act as emergency cover as part of their civil defense role until proper cover can be put in place.
We have a paid corp of trained and experienced medics.
We have emergency situations where experienced medics are required at short notice.
What's the problem deploying them?

Or we can make excuses and dismiss concerns as righteous indignation while recent history repeats itself and our most vulnerable citizens die due to lack of care - literal and metaphorical.

is_that_so

plodder wrote: »

Seems strange that the staff are only getting tested every two weeks. Even a single batch test of all the staff every few days would be better than that.

HSE managed homes are every two weeks. A poster mentioned a private home earlier in the thread where they were tested weekly, privately one would imagine.

VillageIdiot71

Bannasidhe wrote: »

They don't need to 'run' it.
They can act as emergency cover as part of their civil defense role until proper cover can be put in place.
We have a paid corp of trained and experienced medics.
We have emergency situations where experienced medics are required at short notice.
What's the problem deploying them?

Or we can make excuses and dismiss concerns as righteous indignation while recent history repeats itself and our most vulnerable citizens die due to lack of care - literal and metaphorical.

Well, some folk might expect the expertise and training of army medical people might not be a close match to what you need to do in a nursing home.

But, hey, you're a randomer on the internet. Obviously, its as simple as that.

ohnonotgmail

VillageIdiot71 wrote: »

And I'm not particularly defending that.

Just linking to the willingness of Government to close down huge parts of the economy, at great human and financial cost. So, indeed, no problem putting half a million people out of work on the stroke of a pen.

Put another way, its not a resourcing issue. Its a simple unwillingness by HSE staff, such as nurses getting full pay in services that aren't really functional at the moment, to transfer into nursing homes where they might actually have a job to do.

You'll wait, I suspect, before you'll see the issue pitched like that. Easier to blame it all on Stephen Donnelly, as he comes across as a bit gormless.

you described a request for the army to be deployed as "righteous indignation". now you say we should leave the minister alone because he is a bit gormless and blame others. he promised a contingency would be put in place. it wasn't.

VillageIdiot71

ohnonotgmail wrote: »

you described a request for the army to be deployed as "righteous indignation".

That I did.

ohnonotgmail wrote: »

now you say we should leave the minister alone because he is a bit gormless and blame others.

This I didn't do.

I'm not looking to blame anyone.

I am suggesting that, in a context where Government is obviously willing to incur literally billions of euro of cost for very little gain, we'd do well to try to understand why certain things are apparently not possible.

But, sorry, I'm probably misunderstanding the purpose of this conversation. It's probably much more cathartic to rant about sending in the Army.

kirving

VillageIdiot71 wrote: »

Well, some folk might expect the expertise and training of army medical people might not be a close match to what you need to do in a nursing home.

But, hey, you're a randomer on the internet. Obviously, its as simple as that.

Perfection is the enemy of the good. Why is there always an excuse as to why something cannot be done? Not from you specifically, but in general in this country.

Army personnel could absolutely take basic workload (cooking, cleaning, lifting, prepping medicine, etc) to leave specialist tasks to the nurses and care assistants for a period of time.

It's little to do with money, more about management and effectiveness of the HSE as far as I can see.

normanoffside

I don't understand why they aren't testing nursing home staff and residents at least weekly, ideally more than once a week..
Why spend all time and resources testing asymptomatic school kids and young adults 'close contacts' if the capacity is low.
Priority should be given to those that need it most.

is_that_so

normanoffside wrote: »

I don't understand why they aren't testing nursing home staff and residents at least weekly, ideally more than once a week..
Why spend all time and resources testing asymptomatic school kids and young adults 'close contacts' if the capacity is low.
Priority should be given to those that need it most.

When it's not widespread in the community as it is now, it's a waste of resources that could be used on other priorities. There's also an assumption that homes will continue to follow protocols properly.

normanoffside

is_that_so wrote: »

When it's not widespread in the community as it is now, it's a waste of resources that could be used on other priorities. There's also an assumption that homes will continue to follow protocols properly.

Nursing home should be the biggest priority as they have been the source of over 60% of all recorded deaths, not little Johnny in 2nd class with a sniffle.

average_runner

normanoffside wrote: »

I don't understand why they aren't testing nursing home staff and residents at least weekly, ideally more than once a week..
Why spend all time and resources testing asymptomatic school kids and young adults 'close contacts' if the capacity is low.
Priority should be given to those that need it most.

The one my parent is in, the staff are tested every week

normanoffside

average_runner wrote: »

The one my parent is in, the staff are tested every week

That's good to hear but they said last night at the briefing (Colm Henry I think?) that they don't plan to go back to weekly testing as standard and we just need to keep community transmission down.

I know of some nursing home staff who had their tests cancelled about 6 weeks ago as testing couldn't cope with the numbers of school kids getting sent to test centres with sniffles.

suicide_circus

I really hope i dont live long enough to require long term care in a home with my mind gone to mush and my days punctuated by fear, loneliness and personal indignities.

Bannasidhe

VillageIdiot71 wrote: »

Well, some folk might expect the expertise and training of army medical people might not be a close match to what you need to do in a nursing home.

But, hey, you're a randomer on the internet. Obviously, its as simple as that.

And some people might try any old excuse to distract from the utter lack of a contingency plan and dismiss any suggestions as to short term emergency solutions because as a randomer on the internet they can display a callus streak with impunity.

That same randomer, in their eagerness to pour scorn, mightn't even bother their hole to see if the Army Medical Corp has already been deployed to assist during the covid crises.

On 12 March the Defence Forces published a ‘preparedness statement’ regarding Covid-19. It noted that “we have notified our personnel of the impending change to our force posture and all non-essential activities have been suspended”.

“Our focus now is to maximise our preparedness to respond to requests for assistance from the civil authorities.”

Since then, the involvement and support of Defence Forces personnel in the response to Covid-19 has substantially ramped-up.

“The response to Covid-19 is being coordinated under the guidance of the national public health emergency team, whose focus is on maximising and sustaining the support to frontline services for the duration of the response to Covid-19,” a spokesperson for the Defence Forces told the Medical Independent (MI) on 23 March.

https://www.medicalindependent.ie/helping-to-defend-the-nation-from-covid-19/

But sure - no doubt the care assistants paid minimum wage who do the bulk of the work in Nursing homes have skills army medical staff lack.

VillageIdiot71

Bannasidhe wrote: »

That same randomer, in their eagerness to pour scorn, mightn't even bother their hole to see if the Army Medical Corp has already been deployed to assist during the covid crises.

Which means they're not available to operate a 24/7 nursing home.

Bannasidhe wrote: »

But sure - no doubt the care assistants paid minimum wage who do the bulk of the work in Nursing homes have skills army medical staff lack.

Do you really want to keep digging?

Amirani

Dempo1 wrote: »

Hard to know what to make of this appalling situation. Frankly is doesn't matter a damn who runs this home, the HSE have an ultimate responsibility.

This doesn't make any sense. You might as well say the HSE have ultimate responsibility for what happens in schools.

The HSE have no oversight role for private nursing homes. They are not their responsibility at all.

iamwhoiam

VillageIdiot71 wrote: »

Well, some folk might expect the expertise and training of army medical people might not be a close match to what you need to do in a nursing home.

But, hey, you're a randomer on the internet. Obviously, its as simple as that.

Well if I was in that care home with no one looking after me and a nurse worn out and over worked I would welcome the army medical corp to help me . They could easily give out meals, make beds , move patients to the bed or chair etc . Of course they could .
I am a retired nurse and if my patients were in danger of being neglected I would welcome the army with open arms to help me out

ohnonotgmail

Amirani wrote: »

This doesn't make any sense. You might as well say the HSE have ultimate responsibility for what happens in schools.

The HSE have no oversight role for private nursing homes. They are not their responsibility at all.

the HSE were supposed to have a contingency for an outbreak in a nursing home. they didn't.

VillageIdiot71

iamwhoiam wrote: »

Well if I was in that care home with no one looking after me and a nurse worn out and over worked I would welcome the army medical corp to help me . They could easily give out meals, make beds , move patients to the bed or chair etc . Of course they could .
I am a retired nurse and if my patients were in danger of being neglected I would welcome the army with open arms to help me out

Like I said, I may be misunderstanding the purpose of the thread.

If its to help participants to achieve a sense of personal mental wellbeing, they should absolutely follow your lead and post up stream of consciousness nonsense.