RTE Investigates: Inside Ireland's Nursing Homes

Two leading doctors in gerontological care have described as shocking and disturbing undercover footage to be revealed in an RTÉ Investigates documentary tonight examining standards of care in several residential facilities owned by Ireland's largest provider of private nursing homes.

The company at the centre of the allegations, Emeis Ireland – previously known as Orpea – has apologised to residents and their families for the distress caused by the failings identified in the RTÉ report, saying it has launched an in-depth review to immediately address all issues identified.

The investigation which focuses on two nursing homes – The Residence Portlaoise and Beneavin Manor in Glasnevin in north Dublin – uncovered multiple examples of care failings and neglect of vulnerable older residents.

"This is going to shorten people's lives and the lives that they have will be more miserable because of the situation that they're in," said Consultant Geriatrician Prof David Robinson. "It's abuse – there's no other word for it."

Following detailed concerns raised by several whistleblowers, RTÉ Investigates had two undercover researchers simultaneously apply for and secure healthcare assistant roles at the Emeis homes. They both had all the required qualifications and were garda vetted by RTÉ.

At The Residence Portlaoise, where up to 101 residents can be accommodated at a weekly cost of approximately €1,200 per week under the Fair Deal scheme, RTÉ did witness some staff provide good care but more often saw repeated instances of staff shortages impacting daily resident care. The Fair Deal scheme is a state support system that helps cover the cost of nursing home care in Ireland, based on a person's income and assets.

This included large groups of residents being congregated together in day rooms, vulnerable older people being left unsupervised resulting in resident falls and day-to-day requests going unattended to for lengthy periods of time such as pleas to be put to bed or use the toilet.

"What we're looking at is largely institutional abuse and this is neglect in a setting which is supposed to be caring," said Prof Robinson.

RTÉ's undercover carer also witnessed multiple examples of poor manual handling with older residents frequently lifted under the arms and without the required use of proper handling equipment contrary to best practice. On some occasions staff were hampered by a lack of available equipment, while in one instance management also instructed healthcare assistants not to use hoisting equipment in public areas for fear their poor technique would be seen by visitors.

Prof Rónán Collins Consultant Geriatrician said:  "In healthcare what causes burnout is people who go to work and come home day after day feeling frustrated because they're unable to provide the level of care they knew they should be providing or wanted to provide".

In Beneavin Manor, in Dublin, which can provide care for up to 115 adults for approximately €1,400 per week with Fair Deal funding, another RTÉ researcher saw similar patterns of staff under pressure. Staff also faced constant challenges when it came to the supply of essential resources with recurring shortages of basic items such as towels, bedsheets, sanitary wipes and gloves.

"It's pretty shocking to be honest with you," Prof Rónán Collins said. "Really one would have to ask in terms of supply chains why staff don't have access to the equipment to do their job appropriately?"

At Beneavin Manor, RTÉ also witnessed the inappropriate handling of vulnerable residents with frail older people sometimes moved by their clothing instead of using the correct handling equipment mandated in their care plans.

"There's no regard for the person," Prof David Robinson said on seeing RTÉ's footage.

 Another expert, Prof Amanda Phelan,  School of Nursing, DCU asks: "How can staff work under those sorts of conditions? It's very, very challenging." 

Having witnessed repeated poor practices, RTÉ Investigates had both researchers hand in their notice and report all their concerns to management at the nursing homes and to the regulatory body, the Health Information and Quality Authority (HIQA). HIQA told RTÉ both The Residence Portlaoise and Beneavin Manor have set out compliance plans to address issues at their homes with reports from recent inspections of both centres currently being finalised.

In a statement, Emeis Ireland said the evidence of poor care delivery, improper moving and handling of residents, and a lack of dignity and breaches of residents' rights are deeply distressing, adding that it does not tolerate any individual or systemic neglect or practices. Offering its sincere apologies, the company said this is not the standard of care they expect and not what residents and their families deserve. It is also to review staffing allocations at both The Residence Portlaoise and Beneavin Manor.