10 minute read
A SAFE AND SECURE HOME
BRINGING SAFETY TO HOMES
Nursing Homes Ireland CEO Tadhg Daly talks to Adam Hyland about optimism and overcoming the challenges of a very difficult year.
Nursing Homes Ireland, CEO Tadhg Daly. Ayear into the pandemic, we are still faced with some uncertainties, and we can’t say just when we will be able to return to a normal way of life. One thing we are certain of is that COVID-19 has hit senior members of society hardest. It is therefore imperative that we are able to keep this most vulnerable group safe, and this difficult challenge is one that Nursing Homes Ireland (NHI) has worked tirelessly to overcome.
As the national representative body for the private and voluntary nursing home sector, they oversee the operation of the more than 460 nursing homes in Ireland that provide sustainable, high-quality care to more than 25,000 residents by actively supporting and representing their members. As Government and Health guidelines and best practices have seen constant change over the past year, and as this unprecedented health crisis rose, fell and rose again, it has been difficult for all care sectors to keep pace. The core values of Nursing Homes Ireland, however, have meant that they have been able to successfully empower their members with up-to-date information and guidance, influence policy decisions through advocacy, and provide leadership to the sector.
Other core values that have come to the fore over the last year are the promotion of a positive image of the sector and the important role it plays, and partnership with all relevant stakeholders to support the delivery of care.
CHALLENGES
“It has been a difficult year for all of us,” NHI CEO Tadhg Daly tells me as we speak about just how the organisation managed to get to the point where nursing homes are now one of the safest places to be in the country as the third wave threatens society once more. “At the outset, when COVID-19 first arrived, there was maybe a blind spot when it came to nursing homes, and our concern was that while there was a lot of preparation going on, it seemed to focus almost exclusively on the acute hospital system, so we had to work hard to ensure our sector was considered.
“We were carefully monitoring what had been going on overseas
and had noted that COVID-19 was having a serious impact on older, more vulnerable people. We had the same concerns as others about PPE, adequate testing measures, and of course the discharging of people from hospitals to the nursing home setting without having been tested for the virus, which was definitely a contributory factor in the spread of infection within homes.
“These were the early challenges, as was keeping abreast of Government and HSE guidelines that were constantly changing, but we were communicating with our members on a daily basis from February 2020 onwards, updating them on public health guidance so they could be as prepared as they could be, given the enormous challenges we were about to face.”
PROACTIVITY
The important role of communicating with members and advocating for the sector to be considered in all health matters resulted in what CEO Daly says was very positive feedback from all members, who felt they were being given the best possible support they could have in order to successfully manage the situation.
“This positivity came out of our very responsive and proactive approach where we were liaising with the Department of Health, the HSE, HIQA and all of the relevant State bodies, and acting as a conduit for all the advice, information and support that was fed back to our members.”
The proactive approach could be seen in the NHI’s early decision to restrict visiting in March of last year, following a meeting with the Department of Health when concerns over the trajectory of the disease were voiced. This meant the introduction of an essential visitors only rule, and the exclusion of children, with the only exceptions being for palliative care and end of life scenarios.
“We were one of the earliest organisations to make that decision,” CEO Daly says. “Looking back, it is clear to me that there were very high levels of community transmission that were finding their way into nursing homes, and while some people suggested our action was premature, we are confident that we made the right decision.
“These restrictions essentially became part of the national guidance afterwards, and while some of these restrictions were eased towards the end of the summer, unfortunately we are now back in the same difficult position we were in early on.
“But restricting visitors was and is important for everybody at the moment, not least the people who reside in the nursing homes, because health care is for all of us, and we have to balance the risk of COVID-19 with the wellbeing of residents.”
COMMUNICATION
As advocates for private and voluntary nursing home providers, residents and all those who live and work in the sector, the last year has seen NHI’s role increase substantially, with constant communication with the relevant State bodies necessary.
“Prior to COVID-19, we may have met with the Minister for Health twice a year, and Government and State officials occasionally,” CEO Daly says, “but in the peak of the pandemic we were meeting every week. Because of the impact the first wave was having on nursing homes, it was necessary for us to be in weekly consultation with the Minister and daily contact with department officials.
“We needed to ensure that they understood the challenges nursing homes faced on the ground and also what was required in terms of support for the safety and care of the 30,000 people residing in nursing homes across the country.”
VACCINATION
Although there is still some uncertainty regarding when the entire population will receive a vaccine, it must be noted that by the time you read this, every single nursing home resident in Ireland will have received both necessary doses, and that must be seen as a great success for the sector.
“Every vaccination counts, so it was important and we are very thankful that the National Immunisation Advisory Committee prioritised nursing home residents and staff to become the first to receive them,” says CEO Daly.
That rollout in itself was no small undertaking, given that nursing homes are located across the length and breadth of the country.
“We had to ensure good communication between ourselves and all of our members to make sure they all knew what was needed for the rollout of the vaccine,” CEO Daly tells me. “We worked very closely with the HSE to make sure all rollouts were scheduled and carried out in a timely manner, and we made sure that all nursing homes were aware of and prepared for the vaccine to be administered.”
What is also encouraging is that the take-up within nursing homes has been close to 100% for residents and 90% for staff, and Nursing Homes Ireland is continuing to engage with the HSE to ensure nursing homes remain COVID-19 free from now on.
“We are continuously advocating for the vaccination of all people being discharged from hospitals into nursing homes,” CEO Daly says, “so new admissions to nursing homes will be given the vaccine before they leave the hospital as part of a standard testing regime.”
While the vaccine rollout is a major success, there is still a lot of work to be done by Nursing Homes Ireland, with the focus still very much on the trajectory of the infection rates and the emergence of new variants.
“One of the things we are speaking to people in public health about is that while the vaccine is fantastic and a new dawn in some respects, we still need to keep a close eye on infection control measures, and these may be in place for quite some time because we don’t yet know the trajectory of the virus over the next few months,” CEO Daly says.
“One of our main priorities for this year is to get back to safe visiting, so we need to keep an eye on developments. We also need to look at the whole model of care because we have to remember that nursing homes are a home for their residents, and we need to move away from a very clinical model of care, so there needs to be a discussion about how we operate and how we see nursing homes in the future and the sustainability of the sector.
“It is important for us to be proactive in terms of shaping the future of nursing home care. For me, sometimes the language or narrative around older people can be pejorative and sometimes disturbing – terms like the tsunami of older people – but what we should be doing is celebrating the fact that people are living longer, and that we have a range of supports to tend to their care needs.
“We pride ourselves on the fact that we work collaboratively with all stakeholders in the sector, nobody has a monopoly on wisdom. What we need to do is work together, and face the challenge of the integration of the sector, something we look forward to.”
PRAISING STAFF
Tadhg Daly is also keen to point out that none of the achievements of nursing homes in Ireland could have been realised without the dedication of staff, something he feels the whole country needs to recognise.
“Once we are in a safer place, with the vaccination rolled out, it is important to have the ability to reflect and to pay tribute to the staff,” he says. “From nurses to carers to cleaners and kitchen staff, everybody in the sector has worked exceptionally hard in what has been a relentless 12-month period.
“I couldn’t give enough praise for people working in the sector because it has been so hard for them, they have worked in very difficult circumstances, but they have never stopped, and in some cases they have lost people they were close to, people they had known and cared for over a couple of years. It has been tragic on so many levels and upsetting for all concerned. We have put in place psychological support to help people who have been affected in this way. It is very important that we don’t just move on, that we recognise these difficulties.”
These supports include a partnership with AWARE and the Community Foundation for Ireland that employees of nursing homes can avail of, with NHI ensuring all staff know they are in place and free to use if needed. Nursing Homes Ireland is also working with the Hospice Foundation to provide grief management support, while the organisation itself has its own campaign called Caring Together, with videos on the website to promote a better community support and understanding of the nursing home sector and the part it plays in a wellfunctioning health service.
POSITIVITY
Every death from COVID-19 is a tragedy, and with the vulnerable demographic within nursing homes, it was inevitable that many deaths were recorded in this sector, but CEO Daly is keen to point to the overwhelming positivity that can be taken from the way in which the crisis has been handled.
“It must be noted that while there have been a significant number of deaths in the nursing home sector unfortunately, the vast majority of those that contracted COVID-19 in a nursing home made a recovery,” he says, “and that is down to the hard work of many people, not least the staff. Despite the tragedies, we are optimistic about the outcome and we have to be positive, and older people themselves are hugely positive.
“The resilience of the sector and of all of the residents in the nursing homes has been great, and it has been matched by the community at large who have shown their compassion by dropping in gifts to their local nursing home,” he adds. “That has to be acknowledged as well, because there has been a lot of good that has come out of so much suffering.
“We have an increasingly ageing demographic, so the responsibility is on all of us to ensure we have all the supports in place to meet their care needs, and the nursing home sector has a critical role to play in that. We are proud of the care we provide, proud of the staff who have worked so hard, and we look forward to the day when we can safely take a step back to recognise all of the work that has been done.”
